LEGACY DENTAL P.C. NPI 1720144967

NPI Information

  • NPI: 1720144967
  • Provider Name: LEGACY DENTAL P.C.
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 17602 WRIGHT ST
    SUITE 105
    OMAHA, NE
    ZIP 68130
  • Phone: (402) 393-1108

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NPI Details

LEGACY DENTAL P.C. is a general practice dentist in Omaha, NE. The provider is 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. LEGACY DENTAL P.C. NPI is 1720144967. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

17602 WRIGHT ST
SUITE 105
OMAHA, NE
ZIP 68130-097
Phone: (402) 393-1108
Fax: (402) 393-1184

The provider's authorized official is Phillip Tracy Brigden .
The authorized official title is President and has the following contact phone number (402) 393-1108.

The enumeration date for this NPI number is 12/30/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice5969NEBRASKAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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