NPIMap

Organization Active NPI

Unmc College of Dentistry

  • Dentist
  • Omaha, NE
National Provider Identifier
1629158365
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
UNMC COLLEGE OF DENTISTRY
Practice address
8200 Dodge St
2ND Floor SPC Children'S Hospital
Omaha, NE 68114-4113
Phone
(402) 559-6100
Fax
(402) 552-7765
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Authorized official

Name
Dr. Randal L Haack, PH.D.
Title
Assistant Dean of Operations
Phone
(402) 472-3492

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

8200 Dodge St
2ND Floor SPC Children'S Hospital
Omaha, NE 68114-4113

Mailing address

40TH and Holdrege
Room 2106B
Lincoln, NE 68583-0740
Phone (402) 472-3492

Other identifiers 2

IdentifierTypeStateIssuer
10025084700MedicaidNE
2956599MedicaidIA

Other names 1

  • Pediatric Dentistry Other name

National Provider Directory

National Provider Directory
Tax ID family
University of Nebraska at Omaha17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

8200 Dodge St
Fl 2
Omaha, NE 68114
Phone (402) 559-6100

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387411200000",
    "number": "1629158365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40TH AND HOLDREGE",
            "address_2": "ROOM 2106B",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685830740",
            "telephone_number": "402-472-3492",
            "fax_number": "402-472-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 DODGE ST",
            "address_2": "2ND FLOOR SPC CHILDREN'S HOSPITAL",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144113",
            "telephone_number": "402-559-6100",
            "fax_number": "402-552-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNMC COLLEGE OF DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2013-12-19",
        "status": "A",
        "authorized_official_last_name": "HAACK",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ASSISTANT DEAN OF OPERATIONS",
        "authorized_official_telephone_number": "402-472-3492",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025084700",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2956599",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; 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.