Individual provider Active NPI

David J Yeats, DMD

  • General Practice Dentistry
  • Omaha, NE
National Provider Identifier
1427059666
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7115 Issued in NE
Practice address
5305 S 96TH St
Omaha, NE 68127-3317
Phone
(402) 331-0701
Fax
(402) 331-0730
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8559 CO
General Practice Dentistry 1223G0001X 7115 NE Primary

Addresses

Primary practice location

5305 S 96TH St
Omaha, NE 68127-3317

Mailing address

5305 S 96TH St
Omaha, NE 68127-3317
Phone (402) 331-0701

Other identifiers 1

IdentifierTypeStateIssuer
04010443MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160121001255 CO Order and Referring Only - DentistPractitioner - Dentist 6709189970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8559COMDPsychologist
7115NEMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Comfort Dental Past Accepting new patients
Miboca 1 LLC PastSince Oct 19, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1427059666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 S 96TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681273317",
            "telephone_number": "402-331-0701",
            "fax_number": "402-331-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 S 96TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681273317",
            "telephone_number": "402-331-0701",
            "fax_number": "402-331-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEATS",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8559",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "7115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04010443",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.