Eric Deshazer, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6453 Issued in NE

Practice address

5500 S 56TH St
Lincoln, NE 68516-1878

Phone

(402) 423-5055

NPI assigned

Oct 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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

State licenses

Practice roles

Locations

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

• Gracemed Health Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1184691693
  Medicare reassignment NPD
• Affordable Dentures - Lincoln, P.C.

  • Dentist
  • Lincoln, NE
  • NPI 1285778431
  NPD (past) Authorized official
• Gracemed Health Clinic, Inc

  dba GraceMed Downing Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1043646870
  NPD
• Affordable Dentures & Implants - Lincoln III, P.C.

  dba Affordable Dentures & Implants - Lincoln

  • General Practice Dentistry
  • Lincoln, NE
  • NPI 1972338523
  NPD (past)
• Gracemed Health Clinic, Inc

  dba GraceMed Mother Mary Anne Clinic

  • Federally Qualified Health Center (FQHC)
  • Wichita, KS
  • NPI 1275893224
  NPD (past)
• Gracemed Health Clinic, Inc

  dba GraceMed McPherson Family Clinic

  • Federally Qualified Health Center (FQHC)
  • McPherson, KS
  • NPI 1871035709
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619067733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 S 56TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685161878",
            "telephone_number": "402-423-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 S 56TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685161878",
            "telephone_number": "402-423-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHAZER",
        "first_name": "ERIC",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "6453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doris Ann Dermann
• Dermatology Associates of Lincoln, LLC
• Mejra Deronjic
• Victoriya Derun
• Maureen Anne Deryke
• Nancy Despain
• Rachel Noelle Despain, MA
• Jenifer Desrosiers, PLADC, PLMHP
• Madison Sue Detamore
• Andrew Deter

• Dentist in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Dentist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.