NPIMap

Individual provider Active NPI

Callista Marie Holwegner, D.D.S.

  • Dentist
  • Lincoln, NE
National Provider Identifier
1194003624
Registry record updated Aug 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1285 Issued in WY
Practice address
1304 N. 40TH Street
Lincoln, NE 68503
Phone
(307) 421-2346
NPI assigned
Aug 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1285 WY Primary
Dentist 122300000X 95 NE

Addresses

Primary practice location

1304 N. 40TH Street
Lincoln, NE 68503

Mailing address

1304 N 40TH St
Lincoln, NE 68503-2108
Phone (307) 421-2346

Other names 1

  • Dr. Callista Marie Owen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1285WYMDClinical Social Worker
95NEMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1194003624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 N 40TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685032108",
            "telephone_number": "307-421-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 N. 40TH STREET",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "68503",
            "telephone_number": "307-421-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLWEGNER",
        "first_name": "CALLISTA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WY",
            "license": "1285",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "95",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CALLISTA",
            "last_name": "OWEN",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.