Individual provider Active NPI

Jacek D Jasinski, DDS

  • General Practice Dentistry
  • Omaha, NE
National Provider Identifier
1558065821
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7939 Issued in NE
Practice address
2005 N 90TH St
Omaha, NE 68134-6002
Phone
(402) 551-9533
NPI assigned
Mar 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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 7939 NE Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2005 N 90TH St
Omaha, NE 68134-6002

Mailing address

202 S 38TH St Apt 300
Council Bluffs, IA 51501-3398
Phone (847) 770-1716

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230824001325 NE Order and Referring Only - DentistPractitioner - Dentist 2860855822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1558065821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S 38TH ST APT 300",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515013398",
            "telephone_number": "847-770-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 N 90TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681346002",
            "telephone_number": "402-551-9533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASINSKI",
        "first_name": "JACEK",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "7939",
            "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

Verify at the official NPI Registry.