Active NPI
Matthew Masaru Anbe Yen, DDS
- Dentist
- Omaha, NE
National Provider Identifier
1407237407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7216
- Practice address
- 11110 Fort St
#106
Omaha, NE 68164-2183 - Phone
- (402) 492-8300
- NPI assigned
- Jun 15, 2015
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 7216 | NE | Primary |
Addresses
Primary practice location
11110 Fort St
#106
Omaha, NE 68164-2183
Mailing address
3430 Webster St
Omaha, NE 68131-1950
Phone (808) 728-5519
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160504002337 | NE | Order and Referring Only - Other (Non-Physician) | 9638478100 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434326400000",
"number": "1407237407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3430 WEBSTER ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681311950",
"telephone_number": "808-728-5519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11110 FORT ST",
"address_2": "#106",
"city": "OMAHA",
"state": "NE",
"postal_code": "681642183",
"telephone_number": "402-492-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YEN",
"first_name": "MATTHEW",
"middle_name": "MASARU ANBE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-15",
"last_updated": "2015-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NE",
"license": "7216",
"primary": true
}
],
"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, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.