NPIMap

Organization Active NPI

Ponca Tribe of Nebraska

  • Dental Clinic/Center
  • Omaha, NE
National Provider Identifier
1194244939
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PONCA TRIBE OF NEBRASKA
Practice address
2602 J St
Omaha, NE 68107-1643
Phone
(402) 733-3612
NPI assigned
Sep 13, 2017
Organization subpart
Yes
Parent organization
PONCA TRIBE OF NEBRASKAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Larry Voegele
Title
Chief Executive Officer
Phone
(402) 438-9222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2602 J St
Omaha, NE 68107-1643

Mailing address

2602 J St
Omaha, NE 68107-1643
Phone (402) 733-3612

Other practice location 1

1800 Syracuse Ave
Norfolk, NE 68701-2458
Phone (402) 371-8780

Other names 1

  • Fred LeRoy Health and Wellness Center Dental Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Ponca Tribe of Nebraska9 organizations share this tax ID, including this one
Part of
Ponca Tribe of Nebraska

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1194244939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 J ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071643",
            "telephone_number": "402-733-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 J ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071643",
            "telephone_number": "402-733-3612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Syracuse Ave",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "NE",
            "postal_code": "687012458",
            "country_code": "US",
            "telephone_number": "402-371-8780",
            "fax_number": "402-379-4293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PONCA TRIBE OF NEBRASKA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PONCA TRIBE OF NEBRASKA",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "VOEGELE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "402-438-9222",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fred LeRoy Health and Wellness Center Dental Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.