NPIMap

Organization Active NPI

Stark and Johnson LLC

Doing business as Lincoln Pediatric Dentistry

  • Pediatric Dentistry
  • Lincoln, NE
National Provider Identifier
1407105299
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
STARK AND JOHNSON LLC
Doing business as
Lincoln Pediatric Dentistry
Practice address
4301 S 80TH St
Suite a
Lincoln, NE 68516-4404
Phone
(402) 476-4301
Fax
(402) 476-4305
NPI assigned
Sep 7, 2012
Organization subpart
Yes
Parent organization
STARK AND JOHNSON, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Authorized official

Name
Jenni K Wall
Title
Insurance and Billing Manager
Phone
(402) 476-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

4301 S 80TH St
Suite a
Lincoln, NE 68516-4404

Mailing address

4301 S 80TH St
Suite a
Lincoln, NE 68516-4404
Phone (402) 476-4301

Other names 1

  • Lincoln Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Stark and Johnson LLC4 organizations share this tax ID, including this one
Part of
Stark and Johnson LLC

Other organizations with this tax ID 3

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

Locations

4301 S 80th St
Ste A
Lincoln, NE 68516
Phone (402) 476-4301

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1407105299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 S 80TH ST",
            "address_2": "SUITE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164404",
            "telephone_number": "402-476-4301",
            "fax_number": "402-476-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 S 80TH ST",
            "address_2": "SUITE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164404",
            "telephone_number": "402-476-4301",
            "fax_number": "402-476-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARK AND JOHNSON LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STARK AND JOHNSON, LLC",
        "enumeration_date": "2012-09-07",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "JENNI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "INSURANCE AND BILLING MANAGER",
        "authorized_official_telephone_number": "402-476-1500"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.