Active NPI
Jonathan Caleb Sand, D.D.S.
- General Practice Dentistry
- Holdrege, NE
National Provider Identifier
1407167034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6879
- Practice address
- 130 W 14TH Ave
Holdrege, NE 68949-1270 - Phone
- (308) 995-8666
- Fax
- (308) 995-2759
- NPI assigned
- Jun 29, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6879 | NE | Primary |
Addresses
Primary practice location
130 W 14TH Ave
Holdrege, NE 68949-1270
Mailing address
130 W 14TH Ave
Holdrege, NE 68949-1270
Phone (308) 995-8666
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025699000 | Medicaid | NE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6879 | NE | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holdrege Family Dental, L.L.C | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Holdrege, NE
- NPI 1275778227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310342400000",
"number": "1407167034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 W 14TH AVE",
"city": "HOLDREGE",
"state": "NE",
"postal_code": "689491270",
"telephone_number": "308-995-8666",
"fax_number": "308-995-2759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 W 14TH AVE",
"city": "HOLDREGE",
"state": "NE",
"postal_code": "689491270",
"telephone_number": "308-995-8666",
"fax_number": "308-995-2759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAND",
"first_name": "JONATHAN",
"middle_name": "CALEB",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-29",
"last_updated": "2011-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NE",
"license": "6879",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025699000",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Holdrege, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.