OMAHA PERIODONTICS AND IMPLANT DENTISTRY LLC (NPI# 1285278028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285278028 |
| Entity Type | Organization |
| Organization Name | OMAHA PERIODONTICS AND IMPLANT DENTISTRY LLC |
| Practice Address |
624 N 129th St Ste 200 Omaha NE 68154-6110 |
| Practice Telephone | 4024318688 |
| Mailing Telephone | 4024318688 |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2019-11-05 |
| Authorized Official Name | DR. ERICA E JASA (PERIODONTIST) |
| Authorized Official Telephone | 4024318688 |
| Authorized Official Credential | DDS,MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | Dental Providers | ||
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Omaha Periodontics | Doing Business As Name - Organization |
| Street Address |
624 N 129TH ST STE 200 |
| City | OMAHA |
| State | NE |
| Zip Code | 68154-6110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275149262 | Vervech | Counselor | 11422 Miracle Hills Drive, Suite 401, Omaha, NE 68154 | 2020-09-16 |
| 1891318150 | Pure Massage, LLC | Massage Therapist | Pure Massage, LLC, 11316 Davenport St, Omaha, NE 68154 | 2020-05-21 |
| 1326682592 | Andrea Dawn Degner | Counselor | 11580 W. Dodge Frontage Rd, Omaha, NE 68154 | 2019-10-31 |
| 1669035150 | Gerard Thomas IIi | Physical Therapist | Triage LLC, 12020 Pacific Street, Omaha, NE 68154 | 2019-04-19 |
| 1306311352 | Sakrx, LLC | Pharmacy | 624 N 114th St, Omaha, NE 68154 | 2018-10-05 |
| 1033622782 | Raquelle G. Rowe | Registered Nurse | 11840 Nicholas Street Suite 215, Med Staff, Omaha, NE 68154 | 2017-11-15 |
| 1336680396 | Kristi Bose | Nurse Practitioner | 11422 Miracle Hills Dr Ste 401, Omaha, NE 68154 | 2017-03-10 |
| 1326442781 | Heather Andsager | Pharmacy Technician | 13360 California Street, Omaha, NE 68154 | 2014-10-14 |
| 1073917605 | Ann Leever | Pharmacist | 505 N 155th Plaza, Omaha, NE 68154 | 2014-10-10 |
| 1689078222 | Melissa Svec | Emergency Medical Technician, Basic | 1705 N 121st St #203, Omaha, NE 68154 | 2014-10-10 |
| Find all providers in zip 68154 | ||||
| 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 |
| 1669834693 | Great Plains Dental Specialists, PC | Dentist | 615 N 90th St, Omaha, NE 68114-2821 | 2016-03-29 |
| 1730315714 | William Patrick Kelsey V | Dentist | 17785 Mason St, Suite 103, Omaha, NE 68118-3526 | 2009-06-04 |
| 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.