NPIMap

Organization Active NPI

Meadowlark Dental Associates

  • Dentist
  • Kearney, NE
National Provider Identifier
1205912482
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6300 Issued in NE
Legal business name
MEADOWLARK DENTAL ASSOCIATES
Practice address
2907 W 37TH St
Ste B
Kearney, NE 68845
Phone
(308) 234-3668
Fax
(308) 237-5491
NPI assigned
Oct 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael J Bryson, DDSNPI 1568624070
Title
Owner
Phone
(308) 234-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 4638 NE
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 6300 NE Primary

Addresses

Primary practice location

2907 W 37TH St
Ste B
Kearney, NE 68845

Mailing address

2907 W 37TH St
Ste B
Kearney, NE 68845
Phone (308) 234-3668

Other identifiers 1

IdentifierTypeStateIssuer
10025205200MedicaidNJ

Other names 1

  • Michael J Bryson DDS Former legal business name

National Provider Directory

National Provider Directory

Locations

2907 W 37th St
Ste B
Kearney, NE 68845
Phone (308) 234-3668

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205912482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 W 37TH ST",
            "address_2": "STE B",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "68845",
            "telephone_number": "308-234-3668",
            "fax_number": "308-237-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 W 37TH ST",
            "address_2": "STE B",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "68845",
            "telephone_number": "308-234-3668",
            "fax_number": "308-237-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWLARK DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRYSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "308-234-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NE",
            "license": "4638",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NE",
            "license": "6300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025205200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael J Bryson DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.