Lindsey Marie Pederson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7218 Issued in NE

Practice address

221 S Jeffers St
1
North Platte, NE 69101-5371

Phone

(308) 534-4040

Fax

(308) 534-1087

NPI assigned

Jun 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lannae Phelps D.D.S., P.C.

  • General Practice Dentistry
  • North Platte, NE
  • NPI 1306055504
  NPD (past)

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1992186043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S JEFFERS ST",
            "address_2": "1",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691015371",
            "telephone_number": "308-534-4040",
            "fax_number": "308-534-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 S JEFFERS ST",
            "address_2": "1",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691015371",
            "telephone_number": "308-534-4040",
            "fax_number": "308-534-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "LINDSEY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "7218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "7218",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Paxton
• Tiffany Paz
• Leslie Ann Pecharich, MSPAS, PA-C
• Destiny Peck
• Katherine D. Pedersen, RDH, PHRDH
• Diane Peer
• Mary Pelster
• Audri Alexandra Pelton Johnson
• Peoples Family Health SVC Inc
• Jasmine Perez

• General Practice Dentistry in North Platte, NE
• Providers in North Platte, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.