NPIMap

Organization Active NPI

Facial Dimensions, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Grand Island, NE
National Provider Identifier
1760626857
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
4372 Issued in NE
Legal business name
FACIAL DIMENSIONS, P.C.
Practice address
710 W Koenig St
Grand Island, NE 68801-6556
Phone
(308) 384-1172
NPI assigned
Apr 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Authorized official

Name
G A. Peterson, D.D.S., M.D.
Title
President
Phone
(308) 384-1172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 4372 NE Primary

Addresses

Primary practice location

710 W Koenig St
Grand Island, NE 68801-6556

Mailing address

710 W Koenig St
Grand Island, NE 68801-6556
Phone (308) 384-1172

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1760626857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 W KOENIG ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688016556",
            "telephone_number": "308-384-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W KOENIG ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688016556",
            "telephone_number": "308-384-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL DIMENSIONS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "G",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "308-384-1172",
        "authorized_official_credential": "D.D.S., M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NE",
            "license": "4372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.