NPIMap

Organization Active NPI

Dental Professionals of Nebraska, PC

  • General Practice Dentistry
  • Papillion, NE
National Provider Identifier
1376947531
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7180 Issued in NE
Legal business name
DENTAL PROFESSIONALS OF NEBRASKA, PC
Practice address
8420 S 71St PLZ
Suite 107
Papillion, NE 68133-2138
Phone
(402) 682-7579
NPI assigned
Oct 17, 2014
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF NEBRASKA, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Authorized official

Name
Kendra Walker
Title
Credentialing Coordinator
Phone
(217) 540-8312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 7180 NE Primary

Addresses

Primary practice location

8420 S 71St PLZ
Suite 107
Papillion, NE 68133-2138

Mailing address

8420 S 71St PLZ
Suite 107
Papillion, NE 68133-2138
Phone (402) 682-7579

Other names 1

  • Papillion 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.

Locations

8420 S 71st Plz
Ste 107
Papillion, NE 68133
Phone (402) 682-7579

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1376947531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8420 S 71ST PLZ",
            "address_2": "SUITE 107",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "681332138",
            "telephone_number": "402-682-7579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8420 S 71ST PLZ",
            "address_2": "SUITE 107",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "681332138",
            "telephone_number": "402-682-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF NEBRASKA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF NEBRASKA, PC",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8312"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "7180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Papillion Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.