NPIMap

Organization Active NPI

Dental Specialties

  • Pediatric Dentistry
  • Omaha, NE
National Provider Identifier
1952623902
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
4879 Issued in NE
Legal business name
DENTAL SPECIALTIES
Practice address
14133 Q St
Omaha, NE 68137
Phone
(402) 895-1900
Fax
(402) 895-5726
NPI assigned
Feb 18, 2010
Last updated
Feb 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Authorized official

Name
Dr. George Michael Rakes, D.D.S.NPI 1982765962
Title
Owner
Phone
(402) 895-1900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6712 NE
Pediatric Dentistry 1223P0221X 4879 NE Primary
Pediatric Dentistry 1223P0221X 6335 NE

Addresses

Primary practice location

14133 Q St
Omaha, NE 68137

Mailing address

14133 Q St
Omaha, NE 68137
Phone (402) 895-1900

Other identifiers 1

IdentifierTypeStateIssuer
10025232300MedicaidNE

National Provider Directory

National Provider Directory

Locations

14133 Q St
Omaha, NE 68137
Phone (402) 506-5100

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1952623902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14133 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68137",
            "telephone_number": "402-895-1900",
            "fax_number": "402-895-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14133 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68137",
            "telephone_number": "402-895-1900",
            "fax_number": "402-895-5726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALTIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "RAKES",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-895-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6712",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NE",
            "license": "4879",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NE",
            "license": "6335",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025232300",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.