Individual provider Active NPI

Scott Bernard Bicknell

  • Dentist
  • Omaha, NE
National Provider Identifier
1356088967
Registry record updated Jun 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8081 Issued in NE
Practice address
13790 Millard Ave
Omaha, NE 68137-2700
Phone
(402) 896-1999
NPI assigned
May 16, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 8081 NE Primary
Dentist 122300000X 6001070-15 WI

Addresses

Primary practice location

13790 Millard Ave
Omaha, NE 68137-2700

Mailing address

13790 Millard Ave
Omaha, NE 68137-2700

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
6001070-15WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Dental Millard, LLC CurrentSince May 18, 2025 Accepting new patients
Act Dental LLC PastSince May 1, 2022 Accepting new patients

Locations

13790 Millard Ave
Omaha, NE 68137
Phone (402) 896-1999

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749945600000",
    "number": "1356088967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13790 MILLARD AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13790 MILLARD AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372700",
            "telephone_number": "402-896-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICKNELL",
        "first_name": "SCOTT",
        "middle_name": "BERNARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-16",
        "last_updated": "2025-06-15",
        "certification_date": "2025-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "8081",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001070-15",
            "primary": false
        }
    ],
    "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 15, 2025; 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.