Active NPI
Jacob Rhys Bocchino
- General Practice Dentistry
- Omaha, NE
National Provider Identifier
1508552514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 62084
- Practice address
- 2109 Cuming St
Omaha, NE 68102-4325 - Phone
- (816) 805-5572
- NPI assigned
- Apr 13, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 62084 | KS | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2109 Cuming St
Omaha, NE 68102-4325
Mailing address
5410 Neela LN
Corpus Christi, TX 78413-2187
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 |
|---|---|---|---|
| 62084 | KS | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691020800000",
"number": "1508552514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5410 NEELA LN",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784132187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2109 CUMING ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681024325",
"telephone_number": "816-805-5572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOCCHINO",
"first_name": "JACOB",
"middle_name": "RHYS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-13",
"last_updated": "2023-08-03",
"certification_date": "2023-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KS",
"license": "62084",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"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 Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.