NPIMap

Organization Active NPI

Dental Professionals of Nebraska, PC

Doing business as Riverside Crossing Dental Care

  • General Practice Dentistry
  • Elkhorn, NE
National Provider Identifier
1346923042
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF NEBRASKA, PC
Doing business as
Riverside Crossing Dental Care
Practice address
5619 S 204TH Ave
Elkhorn, NE 68022-4285
Phone
(531) 484-3050
Fax
(531) 484-4140
NPI assigned
Aug 9, 2023
Last updated
Aug 9, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF NEBRASKA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Authorized official

Name
Belinda Huerta
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

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

Addresses

Primary practice location

5619 S 204TH Ave
Elkhorn, NE 68022-4285

Mailing address

5619 S 204TH Ave
Elkhorn, NE 68022-4285
Phone (531) 484-3050

Other names 1

  • Riverside Crossing Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Nebraska PC12 organizations share this tax ID, including this one
Part of
Dental Professionals of Nebraska PC

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1346923042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5619 S 204TH AVE",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680224285",
            "telephone_number": "531-484-3050",
            "fax_number": "531-484-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5619 S 204TH AVE",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680224285",
            "telephone_number": "531-484-3050",
            "fax_number": "531-484-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF NEBRASKA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF NEBRASKA, P.C.",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "HUERTA",
        "authorized_official_first_name": "BELINDA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Crossing Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkhorn, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.