NPIMap

Organization Active NPI

Kearney Pediatric Dentistry, L.L.C.

  • Pediatric Dentistry
  • Kearney, NE
National Provider Identifier
1760910194
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
6781 Issued in NE
Legal business name
KEARNEY PEDIATRIC DENTISTRY, L.L.C.
Practice address
218 W 39TH St
Kearney, NE 68845-2802
Phone
(308) 236-5437
NPI assigned
May 30, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Brett J Carranza, PEDIATRIC DENTISTNPI 1407011513
Title
Owner
Phone
(308) 236-5437

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 6781 NE Primary

Addresses

Primary practice location

218 W 39TH St
Kearney, NE 68845-2802

Mailing address

218 W 39TH St
Kearney, NE 68845-2802
Phone (308) 236-5437

National Provider Directory

National Provider Directory

Locations

218 W 39th St
Kearney, NE 68845
Phone (308) 236-6499

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1760910194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 W 39TH ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452802",
            "telephone_number": "308-236-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 W 39TH ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688452802",
            "telephone_number": "308-236-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEARNEY PEDIATRIC DENTISTRY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CARRANZA",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "308-236-5437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PEDIATRIC DENTIST"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NE",
            "license": "6781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.