Active NPI
Roger Joe Fisher, D.D.S.
- General Practice Dentistry
- Lincoln, NE
National Provider Identifier
1609084789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5562
- Practice address
- 5801 S 58TH Street
Suite Aa
Lincoln, NE 68516-6405 - Phone
- (402) 488-2727
- Fax
- (402) 488-4263
- NPI assigned
- May 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5562 | NE | Primary |
Addresses
Primary practice location
5801 S 58TH Street
Suite Aa
Lincoln, NE 68516-6405
Mailing address
5801 S. 58TH Street
Suite Aa
Lincoln, NE 68516-6405
Phone (402) 488-2727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5562 | NE | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341792000000",
"number": "1609084789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5801 S. 58TH STREET",
"address_2": "SUITE AA",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685166405",
"telephone_number": "402-488-2727",
"fax_number": "402-488-4263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5801 S 58TH STREET",
"address_2": "SUITE AA",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685166405",
"telephone_number": "402-488-2727",
"fax_number": "402-488-4263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "ROGER",
"middle_name": "JOE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-20",
"last_updated": "2012-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NE",
"license": "5562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.