NPIMap

Organization Active NPI

SE Nebraska Dental Group, PC

  • Dentist
  • Weeping Water, NE
National Provider Identifier
1992097778
Registry record updated May 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6707 Issued in NE
Legal business name
SE NEBRASKA DENTAL GROUP, PC
Practice address
105 W Eldora Ave
Weeping Water, NE 68463-4201
Phone
(402) 267-2325
Fax
(402) 267-2725
NPI assigned
May 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2011

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

Authorized official

Name
Dr. Matthew C Neumann, DDSNPI 1699765222
Title
Owner
Phone
(402) 267-2325

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 6172 NE
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 6707 NE Primary

Addresses

Primary practice location

105 W Eldora Ave
Weeping Water, NE 68463-4201

Mailing address

105 W Eldora Ave
P.O. Box 403
Weeping Water, NE 68463-4201
Phone (402) 267-2325

Other identifiers 1

IdentifierTypeStateIssuer
10025741800MedicaidNE

National Provider Directory

National Provider Directory

Locations

105 W Eldora Ave
Weeping Water, NE 68463
Phone (402) 267-2325

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305072000000",
    "number": "1992097778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W ELDORA AVE",
            "address_2": "P.O. BOX 403",
            "city": "WEEPING WATER",
            "state": "NE",
            "postal_code": "684634201",
            "telephone_number": "402-267-2325",
            "fax_number": "402-267-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W ELDORA AVE",
            "city": "WEEPING WATER",
            "state": "NE",
            "postal_code": "684634201",
            "telephone_number": "402-267-2325",
            "fax_number": "402-267-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SE NEBRASKA DENTAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2011-05-11",
        "status": "A",
        "authorized_official_last_name": "NEUMANN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-267-2325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NE",
            "license": "6172",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NE",
            "license": "6707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025741800",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weeping Water, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; 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.