PHILLIP TRACY BRIGDEN (NPI# 1013297332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013297332 |
| Entity Type | Individual |
| Full Name | PHILLIP TRACY BRIGDEN |
| Credential | D.D.S. |
| Practice Address |
11919 Grant St Ste 140 Omaha NE 68164-3475 |
| Practice Telephone | 4024934175 |
| Practice Fax Number | 8778118129 |
| Mailing Telephone | 4024934175 |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2019-09-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 5969 | NE | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5969 | NE | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 17602 Wright St, Suite 105, Omaha, NE 681302097 | 4023931108 |
| Street Address |
11919 GRANT ST STE 140 |
| City | OMAHA |
| State | NE |
| Zip Code | 68164-3475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245891035 | Kind Heart Caregivers | Home Health | 10840 Cottonwood Lane Apt 39, 10840 Cottonwood Lane Apt 39, Omaha, NE 68164 | 2019-06-24 |
| 1174082622 | Dana Thiele | Occupational Therapist | 11808 Grant Street, Suite 100, Omaha, NE 68164 | 2019-03-14 |
| 1346709896 | Kelsey Melsheimer | Occupational Therapist | 11808 Grant St Suite 100, Omaha, NE 68164 | 2019-03-14 |
| 1326579202 | Regina Marie Brant | Registered Nurse | 11422 Kansas Circle, Omaha, NE 68164 | 2017-03-23 |
| 1174984140 | Afoua Badjaglana | Physical Therapy Assistant | 3526 N 112th Plz Apt 6, Omaha, NE 68164 | 2016-03-17 |
| 1679966543 | Paige Latino | Physical Therapist | 11808 Grant St, Suite 100, Omaha, NE 68164 | 2015-03-16 |
| 1053716753 | John Bigando | Pharmacist | 13250 W. Maple Road, Omaha, NE 68164 | 2014-10-24 |
| 1063813582 | Yusuke Tanaka | Specialist/Technologist | 10857 Arlington Pz, #1520, Omaha, NE 68164 | 2014-09-16 |
| 1083015515 | Hyunjae Jeon | Specialist/Technologist | 10857 Arlington Plaza, Apt. 1520, Omaha, NE 68164 | 2014-09-16 |
| 1942630389 | Stephanie Nicole Rupp | Dietitian, Registered | 10808 Fort Street, Omaha, NE 68164 | 2013-11-21 |
| Find all providers in zip 68164 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982240024 | Autumn Brown | Dentist | 989375 Nebraska Medical Ctr Fl Center3, Omaha, NE 68198-9375 | 2019-11-25 |
| 1407411507 | Today's Dental 74th Plaza, LLC | Dentist | 900 S 74th Plz Ste 300, Omaha, NE 68114-4667 | 2019-05-03 |
| 1104390855 | Millard Hills Dental Health Center LLC | Dentist | 14202 Y Street, Omaha, NE 68137 | 2019-01-16 |
| 1184119547 | Nbd Lincoln PC | Dentist | 2456 S 120th St, Omaha, NE 68144-2811 | 2018-06-28 |
| 1538664255 | Ss Green & Dentistry Associates LLC | Dentist | 3525 N 147th St Ste 213, Omaha, NE 68116-8262 | 2018-03-26 |
| 1487155073 | Nicole T Nelson | Dentist | 5805 Manderson St, Omaha, NE 68104-2939 | 2018-02-28 |
| 1588176887 | Jerald E. Mcmanigal, Dds, PC | Dentist | 13518 W Center Rd, Omaha, NE 68144-3408 | 2017-10-27 |
| 1467971457 | James Donald O'meara | Dentist | 780729 California Plz, Omaha, NE 68178-0012 | 2017-09-12 |
| 1801318142 | Trason Lyle Shoquist | Dentist | 15304 Howe St, Omaha, NE 68144-5416 | 2017-07-07 |
| 1144750449 | John Paul Kersenbrock | Dentist | 13808 W Maple Rd Ste 112, Omaha, NE 68164-6231 | 2017-06-19 |
| Find all providers in OMAHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.