NPIMap

Organization Active NPI

Midlands Dental Group LLC

  • General Practice Dentistry
  • Bellevue, NE
National Provider Identifier
1558428003
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MIDLANDS DENTAL GROUP LLC
Practice address
712 Fort Crook Rd N
Bellevue, NE 68005-4558
Phone
(402) 733-6066
Fax
(402) 733-0899
NPI assigned
Jan 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Jean Ann Kerger
Title
Corporate Manager
Phone
(712) 642-4136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

712 Fort Crook Rd N
Bellevue, NE 68005-4558

Mailing address

712 Fort Crook Rd N
Bellevue, NE 68005-4558
Phone (402) 733-6066

National Provider Directory

National Provider Directory
Tax ID family
Midlands Dental Centers3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558428003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 FORT CROOK RD N",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680054558",
            "telephone_number": "402-733-6066",
            "fax_number": "402-733-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 FORT CROOK RD N",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680054558",
            "telephone_number": "402-733-6066",
            "fax_number": "402-733-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLANDS DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KERGER",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CORPORATE MANAGER",
        "authorized_official_telephone_number": "712-642-4136",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.