NPIMap

Organization Active NPI

Summit Dental Health - Old Market LLC

  • General Practice Dentistry
  • Omaha, NE
National Provider Identifier
1235547050
Registry record updated Jul 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5290 Issued in NE
Legal business name
SUMMIT DENTAL HEALTH - OLD MARKET LLC
Practice address
1105 Howard St
Omaha, NE 68102-2841
Phone
(402) 502-4424
NPI assigned
Jul 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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

Authorized official

Name
Steve James
Title
Cfo
Phone
(502) 254-8504

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5290 NE Primary

Addresses

Primary practice location

1105 Howard St
Omaha, NE 68102-2841

Mailing address

134 Evergreen Rd Ste 200
Louisville, KY 40243-1486
Phone (502) 254-8500

National Provider Directory

National Provider Directory

Locations

1105 Howard St
Omaha, NE 68102
Phone (402) 502-4424

NPI Registry JSON

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406160000000",
    "number": "1235547050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 EVERGREEN RD STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431486",
            "telephone_number": "502-254-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 HOWARD ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681022841",
            "telephone_number": "402-502-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT DENTAL HEALTH - OLD MARKET LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-24",
        "last_updated": "2014-07-24",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8504"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "5290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 24, 2014; 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.