Samantha J. McKenna, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7446 Issued in NE

Practice address

15813 CW Hadan Dr.
Bennington, NE 68007-2017

Phone

(402) 238-9922

Fax

(402) 238-2424

NPI assigned

Jun 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Samantha J Blaha Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1417305327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15813 CW HADAN DR.",
            "city": "BENNINGTON",
            "state": "NE",
            "postal_code": "680072017",
            "telephone_number": "402-238-9922",
            "fax_number": "402-238-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15813 CW HADAN DR.",
            "city": "BENNINGTON",
            "state": "NE",
            "postal_code": "680072017",
            "telephone_number": "402-238-9922",
            "fax_number": "402-238-2424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1012 Mill Pond Dr",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Greencastle",
            "state": "IN",
            "postal_code": "461352601",
            "country_code": "US",
            "telephone_number": "765-630-3170",
            "fax_number": "765-630-3178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "SAMANTHA",
        "middle_name": "J.",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012509A",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "7446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "BLAHA",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaneisha Marion
• Abby Maroney
• Tracey Marsh
• Flor Mattox
• Tara Mattson, ED.S.
• Pray Meh
• Heather Miller, RD, LMNT, LD
• Marie E Miller, D.C.
• Linda Monroe
• Desena Moo

• General Practice Dentistry in Bennington, NE
• Providers in Bennington, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.