Individual provider Active NPI

Mikala Dein, PHARMD

  • Pharmacist
  • Fremont, NE
National Provider Identifier
1962801332
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13457 Issued in NE
Practice address
3010 E 23Rd St
Fremont, NE 68025-2479
Phone
(402) 727-8772
Fax
(402) 727-0700
NPI assigned
Aug 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13457 NE Primary

Addresses

Primary practice location

3010 E 23Rd St
Fremont, NE 68025-2479

Mailing address

3010 E 23Rd St
Fremont, NE 68025-2479
Phone (402) 727-8772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
13457NEMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1962801332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 E 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252479",
            "telephone_number": "402-727-8772",
            "fax_number": "402-727-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 E 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252479",
            "telephone_number": "402-727-8772",
            "fax_number": "402-727-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIN",
        "first_name": "MIKALA",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "13457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; 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.