PEDIATRIC DENTISTRY OF NEBRASKA (NPI# 1508375023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508375023 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTISTRY OF NEBRASKA |
| Practice Address |
820 W 42nd St Ste 1400 Scottsbluff NE 69361-4704 |
| Mailing Address |
1439 Stillwater Ave Ste 7 Cheyenne WY 82009-7367 |
| Practice Telephone | 3077787100 |
| Mailing Telephone | 3077787100 |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2017-09-27 |
| Authorized Official Name | JONNETTE JONES (OFFICE MANAGER) |
| Authorized Official Telephone | 3077787100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
820 W 42ND ST STE 1400 |
| City | SCOTTSBLUFF |
| State | NE |
| Zip Code | 69361-4704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710592803 | Sara Lynn Luehrs | Counselor | Westmoor Elementary, Scottsbluff Public Schools, 1722 Avenue K, Scottsbluff, NE 69361 | 2020-09-15 |
| 1467924076 | Kelly Jean Betts | Nurse Practitioner | 1601 W. 27th St., Wncc Harms Building, Scottsbluff, NE 69361 | 2018-12-20 |
| 1952824716 | Ellen Otto | Nurse Practitioner | 3210 Ave B, Suite B Quick Care, Scottsbluff, NE 69361 | 2017-07-24 |
| 1518379593 | Suzanne Poynter | Counselor | 14 West 27th, Suite 26, Scottsbluff, NE 69361 | 2014-05-27 |
| 1770834970 | Gabrielle K Mickelson | Dental Hygienist | 204 W 36th St, Scottsbluff, NE 69361 | 2012-09-27 |
| 1225393390 | Brittany R Eirich | Internal Medicine | 3911 Ave B Ste #1100, Scottsbluff, NE 69361 | 2012-07-05 |
| 1548560584 | Western Plains Psychology P.C. | Psychologist | 3911 Ave B, Suite 3400, South Plaza, Scottsbluff, NE 69361 | 2010-10-25 |
| 1033340146 | Bluffs Health Care Clinic | Physician Assistant | 914 W 36th Str, Scottsbluff, NE 69361 | 2009-08-06 |
| 1598972994 | Panhandle Mental Health Center | Case Management | 410 South Beltline, Suite 3, Scottsbluff, NE 69361 | 2007-05-16 |
| 1821201294 | Kay C. Gamet | Social Worker | 4410 Ave D, Scottsbluff, NE 69361 | 2007-05-08 |
| Find all providers in zip 69361 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972148112 | Smile Station Pediatric Dentistry, North LLC | Dentist | 4001 N 168th St, Omaha, NE 68116 | 2019-11-12 |
| 1598243511 | Pediatric Dental Specialists of Greater Nebraska - Omaha, LLC | Dentist | 2410 S 73rd St Ste 203, Omaha, NE 68124-2395 | 2018-08-01 |
| 1083135545 | Roy S Burkhalter IIi | Dentist | 4000 East Campus Loop, Lincoln, NE 68583-0740 | 2017-07-05 |
| 1023481066 | Eric D Hodges Dds PC | Dentist | 2410 So. 73rd St., Omaha, NE 68124-2395 | 2015-11-12 |
| 1407285844 | Smile Station Pediatric Dentistry | Dentist | 6801 S 180th St, Omaha, NE 68135-3264 | 2013-11-06 |
| 1285074443 | Amanda M Snyder | Dentist | 2521 S 119th St, Omaha, NE 68144-2976 | 2013-07-02 |
| 1386984441 | Gregory Fought Dds PC | Dentist | 8600 Executive Woods Dr, Suite 100, Lincoln, NE 68512-9301 | 2013-02-26 |
| 1407105299 | Lincoln Pediatric Dentistry | Dentist | 4301 S 80th St, Suite A, Lincoln, NE 68516-4404 | 2012-09-07 |
| 1255697231 | Smile Station | Dentist | 17935 Welch Plz Ste 104, Omaha, NE 68135-3596 | 2012-04-04 |
| 1598039257 | Lourdes M Secola | Dentist | 14270 W Maple Rd, Omaha, NE 68164-2436 | 2012-02-28 |
| Find all providers with the same taxonomy | ||||
| City | SCOTTSBLUFF |
| Zip Code | 69361 |
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| 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.