|
| |
|
11229 W Dodge Rd Omaha NE 68154-2617 | |
| (402) 593-9911 | |
| (402) 593-0595 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11229 W Dodge Rd, Omaha, Nebraska |
| Authorized Official Name and Position | Shaun O Parker (MANAGER) |
| Authorized Official Contact | 4025939911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
11229 W Dodge Rd Omaha NE 68154-2617 Ph: (402) 593-9911 | 11229 W Dodge Rd Omaha NE 68154-2617 Ph: (402) 593-9911 |
| NPI Number | 1902932502 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902932502 | NPI | - | NPPES |
| 0560516 | Medicaid | IA | |
| 100252051-00 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4895 (Nebraska) | Primary |
Anding Family Dental, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2430 S 73rd St Ste 202, Omaha, NE 68124 Phone: 402-933-4632 | |
Eric D Hodges Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2410 So. 73rd St., Omaha, NE 68124 Phone: 402-397-3377 Fax: 402-343-1039 | |
My Pediatric Dentist West Maple Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 14270 W Maple Rd, Omaha, NE 68164 Phone: 402-491-3100 | |
Dundee Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5006 Dodge St, Omaha, NE 68132 Phone: 402-554-1333 Fax: 402-554-1336 |