Healthcare Provider Details

I. General information

NPI: 1386580827
Provider Name (Legal Business Name): NEBRASKA CITY DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 S 12TH ST
NEBRASKA CITY NE
68410-2304
US

IV. Provider business mailing address

106 S 12TH ST
NEBRASKA CITY NE
68410-2304
US

V. Phone/Fax

Practice location:
  • Phone: 402-873-6373
  • Fax: 402-873-6373
Mailing address:
  • Phone: 402-873-6373
  • Fax: 402-873-6373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM J EINERSON
Title or Position: DENTIST
Credential: EINERSON
Phone: 402-873-6373