Maurice John Kersenbrock, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4971 Issued in NE

Practice address

430 E Everett St
Oneill, NE 68763-1838

Phone

(402) 336-4211

NPI assigned

Oct 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kersenbrock Dental Care LLC

  • General Practice Dentistry
  • O'Neill, NE
  • NPI 1083973671
  NPD (past) Authorized official

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1588653356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E EVERETT ST",
            "city": "ONEILL",
            "state": "NE",
            "postal_code": "687631838",
            "telephone_number": "402-336-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E EVERETT ST",
            "city": "ONEILL",
            "state": "NE",
            "postal_code": "687631838",
            "telephone_number": "402-336-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSENBROCK",
        "first_name": "MAURICE",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "4971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47064746700",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna M. Kaup, APRN
• Nicole Rae Kemp, RDA
• Kersenbrock Dental Care LLC
• John Paul Kersenbrock, DDS
• Mary Kathryn Kersenbrock, D.D.S.
• Scott Klein
• Jonna Marie Kohle, O.D.
• Haley Koopman
• Jacqueline Y Kopecky
• Kacindra Jo Kopf, APRN

• Dentist in O'Neill, NE
• Providers in O'Neill, NE by specialty
• Dentist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.