Individual provider Active NPI

Steven E Weber, D.D.S.

  • General Practice Dentistry
  • Lincoln, NE
National Provider Identifier
1639216070
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6369 Issued in NE
Practice address
3543 S 85TH St Ste 100
Lincoln, NE 68520-1501
Phone
(402) 464-0635
Fax
(402) 464-0804
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6369 NE Primary

Addresses

Primary practice location

3543 S 85TH St Ste 100
Lincoln, NE 68520-1501

Mailing address

3543 S 85TH St Ste 100
Lincoln, NE 68520-1501
Phone (402) 464-0635

Other identifiers 1

IdentifierTypeStateIssuer
47089249100MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20160301000886 NE Order and Referring Only - DentistPractitioner - Dentist 3072818970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6369NEMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1639216070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3543 S 85TH ST STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685201501",
            "telephone_number": "402-464-0635",
            "fax_number": "402-464-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3543 S 85TH ST STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685201501",
            "telephone_number": "402-464-0635",
            "fax_number": "402-464-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "STEVEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47089249100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.