WILDERNESS STATION PEDIATRIC DENTISTRY (NPI# 1568682052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568682052 |
| Entity Type | Organization |
| Organization Name | WILDERNESS STATION PEDIATRIC DENTISTRY |
| Practice Address |
8020 S 13th St Lincoln NE 68512-9371 |
| Practice Telephone | 4024208020 |
| Practice Fax Number | 4024200367 |
| Mailing Telephone | 4024208020 |
| Mailing Fax Number | 4024200367 |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2014-12-23 |
| Authorized Official Name | DR. MARTIN D. KILLEEN (DOCTOR) |
| Authorized Official Telephone | 4024208020 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
6492 | NE | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 10025264500 | 05 |
| Street Address |
8020 S 13TH ST |
| City | LINCOLN |
| State | NE |
| Zip Code | 68512-9371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225070410 | Martin D Killeen | Dentist | 8020 S 13th St, Lincoln, NE 68512-9371 | 2006-06-12 |
| 1144241183 | Gregory Fought | Dentist | 8020 S 13th St, Lincoln, NE 68512-9371 | 2006-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013540673 | Unity Youth & Family Services, LLC | Counselor | 6245 Windhaven Drive, Lincoln, NE 68512 | 2020-02-21 |
| 1568961530 | Japhia Warren | Licensed Practical Nurse | 7001 S. 14th Street, Lincoln, NE 68512 | 2018-02-06 |
| 1225547433 | Costco Wholesale Corportation | Pharmacy | 1620 Pine Lake Road, Lincoln, NE 68512 | 2017-09-20 |
| 1447774427 | Adjusted Life Chiropractic LLC | Chiropractor | 2601 Jamie Ln, Ste 104, Lincoln, NE 68512 | 2017-08-01 |
| 1144740101 | Spencer Norton Brown | Chiropractor | 2600 Jamie Ln, Suite 104, Lincoln, NE 68512 | 2017-06-21 |
| 1669826293 | Shaun Stinson | Dentist | 6835 S. 27th St., Ste 2, Lincoln, NE 68512 | 2016-04-20 |
| 1407100324 | Robert M. Lane | Chiropractor | 1245 Libra Dr., Suite 100, Lincoln, NE 68512 | 2012-10-30 |
| 1689782609 | Lynette S Erickson | Counselor | 5539 S 27th, Suite 101, Lincoln, NE 68512 | 2006-08-29 |
| 1699883561 | Duane E Wade | Physical Therapist | 5633 S 16th St Ste 600, Lincoln, NE 68512 | 2006-08-29 |
| 1548779739 | Costco Wholesale Corportation | Hearing Aid Equipment | 1620 Pine Lake Road, Lincoln, NE 68512 | 2017-09-20 |
| Find all providers in zip 68512 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194212134 | Tooth Spa Dentistry | Clinic/Center | 831 Sterling Pkwy Ste 130, Lincoln, CA 95648-7323 | 2018-04-16 |
| 1417216722 | Dr. Mark Vanicek | Clinic/Center | 6101 Village Dr Ste 102, Lincoln, NE 68516-5830 | 2012-05-07 |
| 1164656781 | Oceans Dental, P.C. | Clinic/Center | 7555 S. 57th Street, Suite 4, Lincoln, NE 68516 | 2009-05-11 |
| 1144737826 | Happy Smile, LLC | Clinic/Center | 885 Smithfield Ave, Lincoln, RI 02865-3508 | 2018-01-04 |
| 1720447444 | Clabaugh Orthodontics, LLC | Clinic/Center | 1530 S 70th St, Suite #201, Lincoln, NE 68506-1567 | 2016-02-23 |
| 1629436019 | Nbd Lincoln PC | Clinic/Center | 6520 Holdrege St, Lincoln, NE 68505-1655 | 2016-02-01 |
| 1407248701 | Sterling Pointe Family Dentistry | Clinic/Center | 800 Sterling Pkwy, Suite 20, Lincoln, CA 95648-8697 | 2015-02-23 |
| 1154750677 | Pediatric Dentistry, P.C. | Clinic/Center | 3901 Pine Lake Rd Ste 250, Lincoln, NE 68516-5497 | 2013-11-05 |
| 1568723294 | Pioneer Greens Dentistry | Clinic/Center | 4444 S 86th St, Lincoln, NE 68526-9253 | 2012-05-29 |
| 1891856712 | Layne P Curnutt Dds Inc | Clinic/Center | 496 East Ave, Lincoln, CA 95648 | 2006-12-13 |
| Find all providers in LINCOLN | ||||
Please comment or provide details below to improve the information on WILDERNESS STATION PEDIATRIC DENTISTRY.
| 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.