Active NPI
Mitchell Jay Henry, M.D., D.D.S.
- Specialist
- Lincoln, NE
National Provider Identifier
1215927181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 18887
- Practice address
- 2222 S 16TH St
Suite 300
Lincoln, NE 68502 - Phone
- (402) 435-0044
- Fax
- (402) 435-7010
- NPI assigned
- Oct 24, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 18887 | NE | Primary |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 5504 | NE |
Addresses
Primary practice location
2222 S 16TH St
Suite 300
Lincoln, NE 68502
Mailing address
2222 S 16TH St
Ste 300
Lincoln, NE 68502
Phone (402) 435-0044
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Plastic and Reconstructive Surgery
- Education
- University of Nebraska College of Medicine, 1990
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2222 S 16TH St
Suite 300
Lincoln, NE 68502-3785
Hospital & facility affiliations
- Bryan Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5504 | NE | MD | Oral and Maxillofacial Surgery (Dentist) |
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lincoln, NE
- NPI 1528006103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1215927181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 S 16TH ST",
"address_2": "STE 300",
"city": "LINCOLN",
"state": "NE",
"postal_code": "68502",
"telephone_number": "402-435-0044",
"fax_number": "402-435-7010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 S 16TH ST",
"address_2": "SUITE 300",
"city": "LINCOLN",
"state": "NE",
"postal_code": "68502",
"telephone_number": "402-435-0044",
"fax_number": "402-435-7010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "MITCHELL",
"middle_name": "JAY",
"credential": "M.D., D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-24",
"last_updated": "2023-09-11",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NE",
"license": "18887",
"primary": true
},
{
"code": "1223S0112X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "NE",
"license": "5504",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.