Active NPI
Dennis E Pestal, DDS
- Dentist
- Beatrice, NE
National Provider Identifier
1972795466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4570
- Practice address
- 3000 Lincoln St
Beatrice State Development Center Dental Clinic
Beatrice, NE 68310-3319 - Phone
- (402) 223-7246
- Fax
- (402) 223-7589
- NPI assigned
- Aug 17, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4570 | NE | Primary |
Addresses
Primary practice location
3000 Lincoln St
Beatrice State Development Center Dental Clinic
Beatrice, NE 68310-3319
Mailing address
3000 Lincoln St
Beatrice State Development Center Dental Clinic
Beatrice, NE 68310-3319
Phone (402) 223-7246
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4570 | NE | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187308800000",
"number": "1972795466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 LINCOLN ST",
"address_2": "BEATRICE STATE DEVELOPMENT CENTER DENTAL CLINIC",
"city": "BEATRICE",
"state": "NE",
"postal_code": "683103319",
"telephone_number": "402-223-7246",
"fax_number": "402-223-7589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 LINCOLN ST",
"address_2": "BEATRICE STATE DEVELOPMENT CENTER DENTAL CLINIC",
"city": "BEATRICE",
"state": "NE",
"postal_code": "683103319",
"telephone_number": "402-223-7246",
"fax_number": "402-223-7589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PESTAL",
"first_name": "DENNIS",
"middle_name": "E",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-17",
"last_updated": "2007-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NE",
"license": "4570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beatrice, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.