Individual provider Active NPI

William Vaughn Kappenman, D.D.S.

  • Dentist
  • Omaha, NE
National Provider Identifier
1932461878
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7019 Issued in NE
Practice address
5011 L St
Omaha, NE 68117-1306
Phone
(402) 731-5423
NPI assigned
Jun 15, 2012
Last updated
Jun 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7019 NE Primary

Addresses

Primary practice location

5011 L St
Omaha, NE 68117-1306

Mailing address

3610 S 49TH St
Omaha, NE 68106-4504
Phone (402) 212-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20160217001365 SD Order and Referring Only - DentistPractitioner - Dentist 1557666245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7019NEMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339718400000",
    "number": "1932461878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 S 49TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681064504",
            "telephone_number": "402-212-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5011 L ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681171306",
            "telephone_number": "402-731-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPPENMAN",
        "first_name": "WILLIAM",
        "middle_name": "VAUGHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2012-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.