NPIMap

Organization Active NPI

Dental Professionals of Nebraska, PC

Doing business as Summit Plaza Dental Care

  • Dentist
  • Bellevue, NE
National Provider Identifier
1558772681
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6878 Issued in NE
Legal business name
DENTAL PROFESSIONALS OF NEBRASKA, PC
Doing business as
Summit Plaza Dental Care
Practice address
3615 Summit Plaza Dr
Suite 101
Bellevue, NE 68123-1003
Phone
(402) 881-8069
NPI assigned
May 12, 2014
Last updated
May 12, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF NEBRASKA, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Authorized official

Name
Allison Varner
Title
Credentialing Coordinator
Phone
(217) 540-6077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6878 NE Primary

Addresses

Primary practice location

3615 Summit Plaza Dr
Suite 101
Bellevue, NE 68123-1003

Mailing address

3615 Summit Plaza Dr
Suite 101
Bellevue, NE 68123-1003
Phone (402) 881-8069

Other names 1

  • Summit Plaza Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Nebraska PC12 organizations share this tax ID, including this one
Part of
Dental Professionals of Nebraska PC

Other organizations with this tax ID 11

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

Locations

3615 Summit Plaza Dr
Ste 101
Bellevue, NE 68123
Phone (402) 502-4994

NPI Registry JSON

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1558772681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 SUMMIT PLAZA DR",
            "address_2": "SUITE 101",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681231003",
            "telephone_number": "402-881-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 SUMMIT PLAZA DR",
            "address_2": "SUITE 101",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681231003",
            "telephone_number": "402-881-8069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF NEBRASKA, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF NEBRASKA, PC",
        "enumeration_date": "2014-05-12",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "VARNER",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6077"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "6878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Plaza Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 12, 2014; 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.