Active NPI
Michael L Thorfinnson, DDS
- Dentist
- Omaha, NE
National Provider Identifier
1477680767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- NE4438
- Practice address
- 12317 Gold Street
Omaha, NE 68144-2760 - Phone
- (402) 330-6400
- Fax
- (402) 330-0107
- NPI assigned
- Feb 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | NE4438 | NE | Primary |
Addresses
Primary practice location
12317 Gold Street
Omaha, NE 68144-2760
Mailing address
12317 Gold Street
Omaha, NE 68144-2760
Phone (402) 330-6400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47058874200 | Medicaid | NE |
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: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160121002606 | NE | Order and Referring Only - Dentist | 0143523365 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NE4438 | NE | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712188800000",
"number": "1477680767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12317 GOLD STREET",
"city": "OMAHA",
"state": "NE",
"postal_code": "681442760",
"telephone_number": "402-330-6400",
"fax_number": "402-330-0107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12317 GOLD STREET",
"city": "OMAHA",
"state": "NE",
"postal_code": "681442760",
"telephone_number": "402-330-6400",
"fax_number": "402-330-0107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORFINNSON",
"first_name": "MICHAEL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-27",
"last_updated": "2024-04-04",
"certification_date": "2023-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NE",
"license": "NE4438",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47058874200",
"state": "NE"
}
],
"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 Apr 4, 2024; 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.