NPIMap

Organization Active NPI

Missouri Valley Dental Group, LLC

  • Dentist
  • Omaha, NE
National Provider Identifier
1407391907
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MISSOURI VALLEY DENTAL GROUP, LLC
Practice address
4620 S 25TH St
Omaha, NE 68107-1764
Phone
(402) 731-2100
NPI assigned
Dec 20, 2016
Organization subpart
Yes
Parent organization
MISSOURI VALLEY DENTAL GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Authorized official

Name
Jeffrey Garvey, DDS
Title
Owner
Phone
(712) 325-1544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4620 S 25TH St
Omaha, NE 68107-1764

Mailing address

4620 S 25TH St
Omaha, NE 68107-1764
Phone (402) 731-2100

National Provider Directory

National Provider Directory
Tax ID family
Missouri Valley Dental Group LLC5 organizations share this tax ID, including this one
Part of
Missouri Valley Dental Group LLC

Other organizations with this tax ID 4

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

Locations

4620 S 25th St
Omaha, NE 68107
Phone (402) 731-2100

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.

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": "1482192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482192000000",
    "number": "1407391907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 S 25TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071764",
            "telephone_number": "402-731-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 S 25TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071764",
            "telephone_number": "402-731-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI VALLEY DENTAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSOURI VALLEY DENTAL GROUP, LLC",
        "enumeration_date": "2016-12-20",
        "last_updated": "2016-12-20",
        "status": "A",
        "authorized_official_last_name": "GARVEY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-325-1544",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "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 Dec 20, 2016; 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.