Individual provider Active NPI

William Mayhan

  • Dentist
  • Omaha, NE
National Provider Identifier
1871941575
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7296 Issued in NE
Practice address
3585 N 168TH CT
Omaha, NE 68116-2201
Phone
(402) 614-7111
Fax
(402) 614-7597
NPI assigned
Jun 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7296 NE Primary

Addresses

Primary practice location

3585 N 168TH CT
Omaha, NE 68116-2201

Mailing address

3585 N 168TH CT
Omaha, NE 68116-2201
Phone (402) 614-7111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160816001876 NE Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 0143514034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1871941575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 N 168TH CT",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681162201",
            "telephone_number": "402-614-7111",
            "fax_number": "402-614-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 N 168TH CT",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681162201",
            "telephone_number": "402-614-7111",
            "fax_number": "402-614-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYHAN",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-03",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.