Walnut Creek Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

6743 Issued in NE

Legal business name

WALNUT CREEK PEDIATRIC DENTISTRY

Practice address

10983 Cumberland Dr
Papillion, NE 68046-3894

Phone

(402) 590-2018

Fax

(402) 590-2019

NPI assigned

Apr 11, 2009

Last updated

Feb 25, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Barry Webber, DDSNPI 1528235744

Title

President, Owner

Phone

(402) 590-2018

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Barry Webber, DDS

  • Pediatric Dentistry
  • Papillion, NE
  • NPI 1528235744
  NPD Authorized official

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

{
    "created_epoch": "1239408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582588800000",
    "number": "1598908279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10983 CUMBERLAND DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680463894",
            "telephone_number": "402-590-2018",
            "fax_number": "402-590-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10983 CUMBERLAND DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680463894",
            "telephone_number": "402-590-2018",
            "fax_number": "402-590-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT CREEK PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-11",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A",
        "authorized_official_last_name": "WEBBER",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "PRESIDENT, OWNER",
        "authorized_official_telephone_number": "402-590-2018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NE",
            "license": "6743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025725600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patti Kay Walling
• Amari Dashawn Walls
• Tyler Robert Walls
• Walmart Inc.
• Walnut Creek Eyecare LLC (Walnut Creek Eyecare)
• Teresa Walsh
• Bethany J Walters
• Michael Walts, MD
• Kathy Wangemann
• Kelcie Ward

• Pediatric Dentistry in Papillion, NE
• Providers in Papillion, NE by specialty
• Pediatric Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.