GREAT PLAINS DENTAL SPECIALISTS, PC (NPI# 1669834693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669834693 |
| Entity Type | Organization |
| Organization Name | GREAT PLAINS DENTAL SPECIALISTS, PC |
| Practice Address |
615 N 90th St Omaha NE 68114-2821 |
| Practice Telephone | 4023304100 |
| Practice Fax Number | 4023304103 |
| Mailing Telephone | 4023304100 |
| Mailing Fax Number | 4023304103 |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2016-03-29 |
| Authorized Official Name | ROBERT CLINE JR. (PRESIDENT/OWNER) |
| Authorized Official Telephone | 4023304100 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
| Street Address |
615 N 90TH ST |
| City | OMAHA |
| State | NE |
| Zip Code | 68114-2821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427155415 | Christopher J Redd | Dentist | 615 N 90th St, Omaha, NE 68114-2821 | 2006-09-20 |
| 1871740340 | Michael Scott Hermsen | Dentist | 615 N 90th St, Omaha, NE 68114-2821 | 2008-08-26 |
| 1235236217 | Larry Johnson Ellison | Dentist | 615 N 90th St, Omaha, NE 68114-2821 | 2006-09-20 |
| 1871690842 | Heartland Endodontic Specialists, LLC | Dentist | 615 N 90th St, Omaha, NE 68114-2821 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689237356 | Jared Nathan Holthaus | Optometrist | 625 N. 98th St, Omaha, NE 68114 | 2019-04-18 |
| 1346701869 | On Site Health and Wellness, LLC | Dietitian, Registered | 7905 Pacific Street, Omaha, NE 68114 | 2019-03-27 |
| 1801301205 | Logan Johnson | Specialist/Technologist | 8803 Webster Plz, Omaha, NE 68114 | 2017-12-06 |
| 1992224687 | Douglas Medical Supplies | Durable Medical Equipment & Medical Supplies | 7914 W Dodge Rd Ste 916, Omaha, NE 68114 | 2017-09-13 |
| 1023568540 | Active Spine Physical Therapy, LLC | Clinic/Center | 10110 Nicholas St Ste 100, Omaha, NE 68114 | 2016-10-07 |
| 1417400706 | Kayla Ann Leddy | Counselor | 7701 Pacific St Ste 100a, Omaha, NE 68114 | 2016-08-03 |
| 1134561103 | Julio Cesar Deleon Iv | Counselor | 9212 California Plaza #308, Omaha, NE 68114 | 2013-07-19 |
| 1477992261 | Nicole Janine Lecci | Dentist | 8910 Indian Hills Drive, Suite 200, Omaha, NE 68114 | 2013-06-14 |
| 1538504436 | Christian Louis Barney | Radiology | 8303 Dodge St Ste Ll6, Omaha, NE 68114 | 2013-05-06 |
| 1558606665 | Nbd Solutions | Durable Medical Equipment & Medical Supplies | 327 N 78 Street, Omaha, NE 68114 | 2012-11-29 |
| Find all providers in zip 68114 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457999815 | Yu-ting Yeh | Dentist | 2109 Cuming St Rm 427h, Omaha, NE 68102-4325 | 2019-12-17 |
| 1790177020 | Daryl E. Malena | Dentist | 10838 Old Mill Rd Ste 8, Omaha, NE 68154-2649 | 2015-02-24 |
| 1093932980 | Scott L Morrison | Dentist | 624 N 129th St # 200, Omaha, NE 68154-6107 | 2007-04-20 |
| 1063533479 | Lawrence Calvin Parrish | Dentist | Creighton University School of Dentistry, 2500 California Plaza, Omaha, NE 68178-0001 | 2007-04-03 |
| 1235292657 | Daryl E. Malena | Dentist | 10838 Old Mill Rd, Suite 8, Omaha, NE 68154-2649 | 2006-12-18 |
| 1528136892 | Steven Jay Gallagher | Dentist | 2233 N 161st St, Omaha, NE 68116-2080 | 2006-12-02 |
| 1831266121 | Dennis Michael Anderson | Dentist | 3635 N 129th St, Omaha, NE 68164-5211 | 2006-11-29 |
| 1982632121 | Timothy Patrick Mcvaney | Dentist | 12165 W Center Road, Suite 76, Omaha, NE 68144-3962 | 2006-06-28 |
| 1730315714 | William Patrick Kelsey V | Dentist | 17785 Mason St, Suite 103, Omaha, NE 68118-3526 | 2009-06-04 |
| 1326200072 | Matthew Ryan Kelsey | Dentist | 17785 Mason St, #103, Omaha, NE 68118-3526 | 2008-06-25 |
| Find all providers in OMAHA | ||||
Please comment or provide details below to improve the information on GREAT PLAINS DENTAL SPECIALISTS, PC.
| 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.