Michael P. McDermott, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4613 Issued in NE

Practice address

14625 California St
Omaha, NE 68154-1950

Phone

(402) 397-7777

Fax

(402) 390-9336

NPI assigned

Jul 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201737600000",
    "number": "1215935259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14625 CALIFORNIA ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681541950",
            "telephone_number": "402-397-7777",
            "fax_number": "402-390-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14625 CALIFORNIA ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681541950",
            "telephone_number": "402-397-7777",
            "fax_number": "402-390-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "MICHAEL",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2008-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NE",
            "license": "4613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NE",
            "identifier": "05570",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47054251501",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandi McDermott
• Brianne E McDermott
• Colin McDermott, APRN
• Julie Ann McDermott, MS, PLMHP
• Mara K McDermott, APRN
• April McDill, DPT
• Heather Joy McDill
• Andrea McDonald, MS, CCC-SLP
• Ayeshia McDonald
• Charlene McDonald

• Oral and Maxillofacial Surgery (Dentist) in Omaha, NE
• Providers in Omaha, NE by specialty
• Oral and Maxillofacial Surgery (Dentist) in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; 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.