Active NPI
Brandi J Dimmitt, DDS
- General Practice Dentistry
- Niobrara, NE
National Provider Identifier
1225199508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6069
- Practice address
- 110 S Visiting Eagle St
Niobrara, NE 68760-7201 - Phone
- (402) 857-2300
- NPI assigned
- Dec 12, 2006
- Last updated
- Jan 21, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6069 | NE | Primary |
Addresses
Primary practice location
110 S Visiting Eagle St
Niobrara, NE 68760-7201
Mailing address
110 S Visiting Eagle St
Niobrara, NE 68760-7201
Phone (402) 857-2300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025439300 | Medicaid | NE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6069 | NE | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453334400000",
"number": "1225199508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 S VISITING EAGLE ST",
"city": "NIOBRARA",
"state": "NE",
"postal_code": "687607201",
"telephone_number": "402-857-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 S VISITING EAGLE ST",
"city": "NIOBRARA",
"state": "NE",
"postal_code": "687607201",
"telephone_number": "402-857-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMMITT",
"first_name": "BRANDI",
"middle_name": "J",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-12",
"last_updated": "2016-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NE",
"license": "6069",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025439300",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Niobrara, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.