KELLEY CARLSON (NPI# 1528411444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528411444 |
| Entity Type | Individual |
| Full Name | KELLEY CARLSON |
| Credential | DDS |
| Practice Address |
2141 S 63rd St Omaha NE 68106 |
| Mailing Address |
2141 S 63rd St Omaha NE 68106-2144 |
| Practice Telephone | 4025511811 |
| Mailing Telephone | 4025511811 |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2019-08-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 7292 | NE | Dental Providers |
| N | 122300000X | Dentist | 61343 | KS | Dental Providers |
| N | 122300000X | Dentist | RES-1326 | OK | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 35-2382039 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1201 N Stonewall Ave, 261, Oklahoma City, OK 731171214 | 4052715222 | |
| 2141 S 63rd St, Omaha, NE 68106 | 4025511811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568786739 | Kelley Renea Carlson | Physical Therapist | 101 W End Ave, Apt 23d, New York, NY 10023-6349 | 2010-03-17 |
| 1710113063 | Kelley Carlson | Emergency Medicine | 1000 Blythe Blvd, Charlotte, NC 28203-5812 | 2009-06-01 |
| Street Address |
2141 S 63RD ST |
| City | OMAHA |
| State | NE |
| Zip Code | 68106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366005209 | Today's Dentistry At Aksarben, LLC | Dentist | 2141 S 63rd St, Omaha, NE 68106-2144 | 2019-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912477571 | Cara Ann Ehegartner | Counselor | 6818 Grover St Suite 200, Omaha, NE 68106 | 2018-11-27 |
| 1861961401 | Kara D. Legrow | Counselor | Legrow Therapy Services, 6910 S Pacific St., Ste #320, Omaha, NE 68106 | 2018-11-13 |
| 1154896249 | Bina Bastola | Registered Nurse | 4444marinda Street, Omaha, NE 68106 | 2018-10-04 |
| 1508354242 | Joshua Michael Brown | Psychologist | 6818 Grover St Ste 301a, Omaha, NE 68106 | 2018-04-27 |
| 1518482629 | Robert Elmore | Pathology | 7710 Mercy Road, Suite 202 - Cu Dept of Pathology, Omaha, NE 68106 | 2017-08-09 |
| 1902331911 | Takeaki Ando | Student in an Organized Health Care Education/Training Program | 6910 Spring Street Apartment 316, Omaha, NE 68106 | 2017-04-27 |
| 1881130482 | Maverick Family Chiropractic, LLC | Chiropractor | 5002 Center St., Suite 4, Omaha, NE 68106 | 2017-01-06 |
| 1598161911 | Nao Kozawa | Specialist/Technologist | 1102 S 60th St, Omaha, NE 68106 | 2014-11-12 |
| 1568866341 | Joel Peck | Pharmacist | 888 South Saddlecreek Rd, Omaha, NE 68106 | 2014-10-22 |
| 1255634531 | Thurman Psychological LLC | Psychologist | 6818 Grover St., Ste. 305, Omaha, NE 68106 | 2010-12-08 |
| Find all providers in zip 68106 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639797194 | Jared Matthew Homan | Dentist | 11840 Nicholas St Ste 210, Omaha, NE 68154-4475 | 2020-07-10 |
| 1114563970 | Corinne Marie Van Osdel | Dentist | 4400 Emile St # 3602, Omaha, NE 68198-0600 | 2019-11-26 |
| 1285278028 | Omaha Periodontics and Implant Dentistry LLC | Dentist | 624 N 129th St Ste 200, Omaha, NE 68154-6110 | 2019-11-05 |
| 1972162493 | Luke Riley Bessmer | Dentist | 8910 Indian Hills Dr Ste 200, Omaha, NE 68114-4127 | 2019-06-08 |
| 1902381247 | Laura Breanna Videtich | Dentist | 5331 S 118th Ct Apt 301, Omaha, NE 68137-3811 | 2018-10-02 |
| 1336620939 | Omar I Faraj | Dentist | 985527 Nebraska Medical Ctr, Omaha, NE 68198-5527 | 2018-08-22 |
| 1225524770 | Mahum Abbas Mirza | Dentist | 13625 California St Ste 300, Omaha, NE 68154-5246 | 2018-07-09 |
| 1346759222 | John Varner | Dentist | 984125 Nebraska Medical Center, Omaha, NE 68198-0001 | 2017-09-23 |
| 1538685698 | Nicholas Samuelson | Dentist | 13808 W Maple Rd Ste 104, Omaha, NE 68164-6231 | 2017-08-20 |
| 1477083046 | Katie Jo Walker | Dentist | 17810 Pierce Plz Ste 100, Omaha, NE 68130-1018 | 2017-06-15 |
| Find all providers in OMAHA | ||||
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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.