NPIMap

Organization Active NPI

University Dental Associates

  • Dentist
  • Lincoln, NE
National Provider Identifier
1780772301
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
UNIVERSITY DENTAL ASSOCIATES
Doing business as
University Dental Associates
Practice address
4000 E Campus Loop S RM 2037
Lincoln, NE 68583-0740
Phone
(402) 472-8900
Fax
(402) 472-0048
NPI assigned
Oct 10, 2006
Last updated
Jan 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Authorized official

Name
Dr. David Gene Berkheim, DDSNPI 1851510937
Title
Executive Dierector
Phone
(402) 472-2345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NE Primary

Addresses

Primary practice location

4000 E Campus Loop S RM 2037
Lincoln, NE 68583-0740

Mailing address

4000 E Campus Loop S RM 2037
Lincoln, NE 68583-0740
Phone (402) 472-8900

Other identifiers 1

IdentifierTypeStateIssuer
576249MedicaidIA

Other names 1

  • University Dental Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318000946 NE Part B Supplier - Clinic/Group Practice 7012807498 Receives reassigned benefits from 3 practitioners
Practice locations: Lincoln, NE

National Provider Directory

National Provider Directory
Tax ID family
University Dental Assoc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4000 E Campus Loop S
Rm 2037
Lincoln, NE 68583
Phone (402) 472-1296

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1780772301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 E CAMPUS LOOP S RM 2037",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685830740",
            "telephone_number": "402-472-8900",
            "fax_number": "402-472-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 E CAMPUS LOOP S RM 2037",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685830740",
            "telephone_number": "402-472-8900",
            "fax_number": "402-472-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "BERKHEIM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "EXECUTIVE DIERECTOR",
        "authorized_official_telephone_number": "402-472-2345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "576249",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Dental Associates",
            "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 Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.