Individual provider Active NPI

Maria Tanchuling Nosworthy, DDS

  • Dentist
  • Bellevue, NE
National Provider Identifier
1629197579
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6669 Issued in NE
Practice address
900 W Mission Ave
Bellevue, NE 68005-3945
Phone
(402) 291-5842
Fax
(402) 291-1621
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6669 NE Primary

Addresses

Primary practice location

900 W Mission Ave
Bellevue, NE 68005-3945

Mailing address

838 Hidden Hills Dr
Bellevue, NE 68005-2738
Phone (402) 291-5485

Other identifiers 1

IdentifierTypeStateIssuer
10025186200MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20230714003568 IA Practitioner - Dentist 0749640225 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6669NEMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Dental Care PC Dentist CurrentSince Jun 13, 2023 Accepting new patients
Towne Dental Past Accepting new patients

Locations

400 Locust St
Ste 400
Des Moines, IA 50309
Phone (515) 664-2681

8500 W 110th St
Ste 450
Overland Park, KS 66210
Phone (913) 362-1112

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629197579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 HIDDEN HILLS DR",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680052738",
            "telephone_number": "402-291-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W MISSION AVE",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680053945",
            "telephone_number": "402-291-5842",
            "fax_number": "402-291-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOSWORTHY",
        "first_name": "MARIA",
        "middle_name": "TANCHULING",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "6669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025186200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

Verify at the official NPI Registry.