Individual provider Active NPI

Will P Gudenrath, DDS

  • Dentist
  • Omaha, NE
National Provider Identifier
1316508187
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7557 Issued in NE
Practice address
2430 S 73Rd St
Omaha, NE 68124-2397
Phone
(402) 991-9243
NPI assigned
Jun 24, 2019
Last updated
Jun 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7557 NE Primary

Addresses

Primary practice location

2430 S 73Rd St
Omaha, NE 68124-2397

Mailing address

7517 Hascall St
Omaha, NE 68124-3442
Phone (402) 238-4928

Other practice location 1

2115 14th St Ste 200
Auburn, NE 68305-1760
Phone (402) 274-3709

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

LicenseStateTypeSpecialty
7557NEMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Auburn Smiles LLC PastSince Aug 27, 2023 Accepting new patients
Conrad Dental P.C. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1316508187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7517 HASCALL ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243442",
            "telephone_number": "402-238-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 S 73RD ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242397",
            "telephone_number": "402-991-9243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2115 14th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "NE",
            "postal_code": "683051760",
            "country_code": "US",
            "telephone_number": "402-274-3709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUDENRATH",
        "first_name": "WILL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7557",
            "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 Jun 24, 2019; 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.