Active NPI
Shelby J Tessendorf, DDS
- Dentist
- Lincoln, NE
National Provider Identifier
1508187915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6899
- Practice address
- 600 S 70TH St
Lincoln, NE 68510-2451 - Phone
- (402) 486-7841
- NPI assigned
- Jun 20, 2010
- Last updated
- Nov 17, 2015
- Sex
- Female
- 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 | 6899 | NE | Primary |
Addresses
Primary practice location
600 S 70TH St
Lincoln, NE 68510-2451
Mailing address
600 S 70TH St
Lincoln, NE 68510-2451
Phone (402) 486-7841
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6899 | NE | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447718400000",
"number": "1508187915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 S 70TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102451",
"telephone_number": "402-486-7841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 S 70TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102451",
"telephone_number": "402-486-7841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TESSENDORF",
"first_name": "SHELBY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-20",
"last_updated": "2015-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NE",
"license": "6899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.