NPIMap

Organization Active NPI

Mark Nielsen DDS, PC

  • Dental Clinic/Center
  • Elkhorn, NE
National Provider Identifier
1780075408
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
6379 Issued in NE
Legal business name
MARK NIELSEN DDS, PC
Practice address
1908 N 203Rd St
Elkhorn, NE 68022-2889
Phone
(402) 289-2036
Fax
(402) 289-5694
NPI assigned
Feb 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Authorized official

Name
Dr. Mark Andrew Nielsen, DDS
Title
Owner
Phone
(402) 289-2036

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 6379 NE Primary

Addresses

Primary practice location

1908 N 203Rd St
Elkhorn, NE 68022-2889

Mailing address

1908 N 203Rd St
Elkhorn, NE 68022-2889
Phone (402) 289-2036

National Provider Directory

National Provider Directory

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": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1780075408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 N 203RD ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680222889",
            "telephone_number": "402-289-2036",
            "fax_number": "402-289-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 N 203RD ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680222889",
            "telephone_number": "402-289-2036",
            "fax_number": "402-289-5694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK NIELSEN DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-17",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-289-2036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NE",
            "license": "6379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.