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PINE LAKE DENTAL
NPI 1194897058
Dentist - General Practice in Grand Island, NE

Active since November 15, 2006
2504 NORTH WEBB RD, GRAND ISLAND, NE 68803(308) 381-7077(308) 381-1345 Get Directions Write a Review

NPPES record last updated: July 6, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pine Lake Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINE LAKE DENTAL (NPI 1194897058) is a healthcare organization registered as a general practice in Grand Island, Nebraska and active in the NPI registry since November 2006. The organization lists Edward E. Quincy, President, as its authorized official.

NPPES Registry Identity

NPI1194897058
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameK Q DENTAL PC
Location Address2504 NORTH WEBB RDGrand Island, NE 68803
Mailing AddressPo Box 87Newman Grove, NE 68758
Phone(308) 381-7077
Fax(308) 381-1345
Organization SubpartNo
Authorized OfficialEdward E. QuincyPresident · (402) 447-6042
Enumeration DateNovember 15, 2006
Last NPPES UpdateJuly 6, 2009
✔ NPI 1194897058 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses✔ Licensed in NE · 6834✔ Licensed in NE · 5962✔ Licensed in NE · 5954✔ Licensed in NE · 3376✔ Licensed in NE · 5746✔ Licensed in NE · 3530✔ Licensed in NE · 6365✔ Licensed in NE · 4543✔ Licensed in NE · 5343✔ Licensed in NE · 4467✔ Licensed in NE · 5838✔ Licensed in NE · 6759✔ Licensed · 6837
Definition
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.
2504 NORTH WEBB RD, Grand Island, NE 68803
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Other Names 1

Doing Business AsPine Lake Dental

Other Identifiers 8

Medicaid=========04NE
Medicaid=========31NE
Medicaid=========06NE
Medicaid=========05NE
Medicaid=========03NE
Medicaid=========13NE
Medicaid=========20NE
Medicaid=========17NE

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is K Q Dental PC's NPI number?

The NPI number for K Q Dental PC is 1194897058. It was assigned to this organization in the NPPES registry on November 15, 2006. The provider is doing business as Pine Lake Dental.

Where is K Q Dental PC located?

K Q Dental PC is located at 2504 North Webb Rd, Grand Island, NE 68803. The listed phone number is (308) 381-7077.

What is K Q Dental PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for K Q Dental PC was last updated on July 6, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.