Organization Active NPI

East Lincoln Dental LLC

  • General Practice Dentistry
  • Lincoln, NE
National Provider Identifier
1770039265
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5965 Issued in NE
Legal business name
EAST LINCOLN DENTAL LLC
Practice address
6930 L St
Suite B
Lincoln, NE 68510-2411
Phone
(402) 489-6547
Fax
(402) 420-7045
NPI assigned
Aug 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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

Authorized official

Name
Bonnie Gall
Title
Office Manager
Phone
(402) 904-6005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5965 NE Primary

Addresses

Primary practice location

6930 L St
Suite B
Lincoln, NE 68510-2411

Mailing address

6040 Village Dr
Suite B
Lincoln, NE 68516-6640
Phone (402) 420-2222

Other names 1

  • East Lincoln Dental Doing business as

National Provider Directory

National Provider Directory

Locations

6930 L St
Ste B
Lincoln, NE 68510
Phone (402) 489-6547

6040 Village Dr
Ste B
Lincoln, NE 68516

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1770039265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 VILLAGE DR",
            "address_2": "SUITE B",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685166640",
            "telephone_number": "402-420-2222",
            "fax_number": "402-420-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6930 L ST",
            "address_2": "SUITE B",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102411",
            "telephone_number": "402-489-6547",
            "fax_number": "402-420-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST LINCOLN DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-25",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "GALL",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "402-904-6005"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "5965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Lincoln Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.