KELSEY PERIODONTAL GROUP, LLC (NPI# 1831423177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831423177 |
| Entity Type | Organization |
| Organization Name | KELSEY PERIODONTAL GROUP, LLC |
| Practice Address |
17785 Mason St Suite 103 Omaha NE 68118-3526 |
| Practice Telephone | 4029344745 |
| Practice Fax Number | 4029344760 |
| Mailing Telephone | 4029344745 |
| Mailing Fax Number | 4029344760 |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2009-09-18 |
| Authorized Official Name | DR. WILLIAM PATRICK KELSEY V (OWNER) |
| Authorized Official Telephone | 4029344745 |
| Authorized Official Credential | D.D.S., M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
6632 | NE | Ambulatory Health Care Facilities |
| Street Address |
17785 MASON ST SUITE 103 |
| City | OMAHA |
| State | NE |
| Zip Code | 68118-3526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285802538 | Becker Chiropractic LLC | Chiropractor | 17785 Mason St, Suite 101, Omaha, NE 68118 | 2008-02-20 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932644127 | Renal Care Group of The Midwest, Inc. | Clinic/Center | 15801 West Dodge Road, Omaha, NE 68118 | 2016-12-27 |
| 1982091583 | Andrew Siref | Student in an Organized Health Care Education/Training Program | 16622 Howard Cir, Omaha, NE 68118 | 2015-04-21 |
| 1942628839 | Deirdre Anne Stolmeier | Dermatology | 515 N 162nd Ave Ste 302, Omaha, NE 68118 | 2014-03-28 |
| 1457625782 | James Clark | Pharmacist | 16130 Parker St, Omaha, NE 68118 | 2012-03-05 |
| 1619102613 | Children's West Village Pointe - Diagnostic Services | Spec/Tech, Pathology | 110 North 175 Street, Children's West Village Pointe - Diagnostic Services, Omaha, NE 68118 | 2009-05-19 |
| 1033359732 | Children's Hospital | Pediatrics | 110 North 175 Street, Suite 1000, Children's Hospital - Urgent Care - West Village Pointe, Omaha, NE 68118 | 2009-02-20 |
| 1598940611 | Dane Patrick Becker | Chiropractor | 17785 Mason St., Suite 101, Omaha, NE 68118 | 2008-01-08 |
| 1700951779 | Karoline S Anderson | Pediatrics | 16811 Burke Street, Ste 101, Omaha, NE 68118 | 2006-11-22 |
| 1154435691 | Scott M Debates | Dermatology | 515 N 162nd Avennue, Ste. 302, Omaha, NE 68118 | 2006-08-19 |
| 1417968645 | Pacific Springs Physical Therapy, PC | Physical Therapist | 1021 S 178th Street, Omaha, NE 68118 | 2006-08-11 |
| Find all providers in zip 68118 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457984817 | Dudzinski Dental PC | Clinic/Center | 3423 S 72nd St, Omaha, NE 68124-3573 | 2020-02-13 |
| 1295251023 | Matthew L. Freyer, D.d.s., P.C. | Clinic/Center | 8424 W Center Rd Ste 100, Omaha, NE 68124-3138 | 2017-08-14 |
| 1699296368 | Thomas M. Sanders Dds, LLC | Clinic/Center | 9961 S. 168th St., Omaha, NE 68136 | 2017-07-03 |
| 1477818862 | 7 Day Dental of Omaha, LLC | Clinic/Center | 7337 Farnam St, Omaha, NE 68114-4627 | 2012-07-11 |
| 1831326826 | Omalee Dental LLC | Clinic/Center | 14 Sixth Ave, Omaha, GA 31821 | 2009-06-17 |
| 1043818438 | Miboca 1 LLC | Clinic/Center | 5305 S 96th St, Omaha, NE 68127-3317 | 2020-10-16 |
| 1629690318 | Smith & Hascall Family Dentistry LLC | Clinic/Center | 17725 Welch Plz Ste B, Omaha, NE 68135-1404 | 2020-05-15 |
| 1669036042 | Nia Jones Orthodontics PC | Clinic/Center | 14707 California St Ste 8, Omaha, NE 68154-1900 | 2019-05-01 |
| 1326535261 | Dylan C Gaillard, Dds, LLC | Clinic/Center | 12828 Augusta Ave, Omaha, NE 68144-3733 | 2018-04-17 |
| 1700373602 | Dylan C Gaillard, Dds, LLC | Clinic/Center | 2526 S 140th St, Omaha, NE 68144-2339 | 2018-04-16 |
| 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.