BELLEVUE ORAL AND MAXILLOFACIAL SURGERY


Address: 1004 Lincoln Rd Ste 102, Bellevue, NE 68005-2341
Phone: 4022509097

BELLEVUE ORAL AND MAXILLOFACIAL SURGERY (NPI# 1467901405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1467901405
Entity Type Organization
Organization Name BELLEVUE ORAL AND MAXILLOFACIAL SURGERY
Practice Address 1004 Lincoln Rd Ste 102
Bellevue
NE 68005-2341
Practice Telephone 4022509097
Mailing Telephone 4022509097
Enumeration Date 2016-10-03
Last Update Date 2016-10-03
Authorized Official Name KYLE DAVID SMITH (MEMBER)
Authorized Official Telephone 4022509097
Authorized Official Credential D.D.S.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QS0112X Clinic/Center
Specialization: Oral and Maxillofacial Surgery
7206 NE Ambulatory Health Care Facilities

Office Location

Street Address 1004 LINCOLN RD STE 102
City BELLEVUE
State NE
Zip Code 68005-2341

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1750988325 Melissa Ann Jansen Social Worker Mission Middle School, Bellevue, NE 68005 2020-10-06
1295352144 Angel Lowery Counselor 112 E Mission Ave, Bellevue, NE 68005 2020-06-26
1760915656 Maria Clark Counselor 1620 Wilshire Dr Ste 222, Bellevue, NE 68005 2017-04-06
1427420512 Daryan Whaler Specialist/Technologist 1000 Galvin Rd S, Bellevue, NE 68005 2015-10-28
1750704623 Joseph Gavis Councill IIi Nurse Practitioner 919 Galvin Rd. S., Suite A, Bellevue, NE 68005 2014-01-29
1205265501 Rebecca Parsons Speech-Language Pathologist 510 W 22nd Avenue, Bellevue, NE 68005 2013-11-06
1649524174 Tammy Lee Winkler-bitzes Physical Therapist 1820 Hillcrest Dr Suite A, Belleuve, NE 68005 2012-11-06
1811268311 Charice M Butler Counselor 919 Galvin Rd S. Ste A, Bellevue, NE 68005 2012-01-16
1184991945 Angela M Matney Pharmacist Hwy 370 & Galvin Road, Bellevue, NE 68005 2011-11-22
1770878852 Sarah Cathryn Sedlak Physical Therapist 2206 Longo Drive, Ste 211, Excel Physical Therapy, Bellevue, NE 68005 2011-06-16
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Taxonomy Information

Taxonomy Code 261QS0112X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1700180452 Village Pointe Oral Surgery P.C. Clinic/Center 17404 Burke St, Omaha, NE 68118-2233 2011-01-10

Competitor

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City BELLEVUE
Zip Code 68005

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Dataset Information

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.

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