Countryside Pediatric Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

COUNTRYSIDE PEDIATRIC DENTISTRY

Practice address

3310 S Cornhusker Dr
York, NE 68467

Phone

(402) 200-3971

NPI assigned

Jul 15, 2024

Last updated

Jul 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bailey Neville, DDSNPI 1760113328

Title

Owner, Dentist

Phone

(402) 853-1771

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bailey Neville, DDS

  • Dentist
  • Omaha, NE
  • NPI 1760113328
  NPD Authorized official

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1336986447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 ROAD P",
            "city": "YORK",
            "state": "NE",
            "postal_code": "684677555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 S CORNHUSKER DR",
            "city": "YORK",
            "state": "NE",
            "postal_code": "68467",
            "telephone_number": "402-200-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-05",
        "status": "A",
        "authorized_official_last_name": "NEVILLE",
        "authorized_official_first_name": "BAILEY",
        "authorized_official_title_or_position": "OWNER, DENTIST",
        "authorized_official_telephone_number": "402-853-1771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Collingham, MSED
• Beverly Collingham
• Shaylee Collingham
• Heidi J Combs, PA-C
• Katie Ruth Comer, DDS
• Craig E. Riley, D.P.M., P.C. (York Foot Clinic)
• Jessica Crane, MOT, OTR/L
• Robert Cunningham
• Angel Dale, CHW
• Jerika D Davis

• Dental Clinic/Center in York, NE
• Providers in York, NE by specialty
• Dental Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.