Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shadow Ridge Dental

Organization General Practice Dentistry · NPI 1073811014

Shadow Ridge Dental is a General Practice Dentistry in Elkhorn, Nebraska. Licensed in Nebraska. Registered with an NPI since 2011.

Licensed in
NE
In the registry since
2011
Specialties on file
2

Practice location Address checks out

19103 Mason Plz
Elkhorn, NE 68022-5659
Phone: (402) 933-0525
Fax: (402) 933-2925
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 4791 (NE)
General Practice Dentistry Taxonomy 1223G0001X · Licence 4488 (NE)

Record details

NPI number1073811014
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official James Becker — Owner · (402) 933-0525
NPI enumeratedFebruary 28, 2011
Last updated in NPPESFebruary 28, 2011
Mailing address19103 Mason Plz, Elkhorn, NE 68022-5659

Other providers in Elkhorn