Individual provider Active NPI

Baylor Devries, DDS

  • Dentist
  • Elkhorn, NE
National Provider Identifier
1063205193
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8087 Issued in NE
Practice address
18140 Burke St Ste 100
Elkhorn, NE 68022-4433
Phone
(402) 934-5200
Fax
(402) 537-4346
NPI assigned
May 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8087 NE Primary

Addresses

Primary practice location

18140 Burke St Ste 100
Elkhorn, NE 68022-4433

Mailing address

18140 Burke St Ste 100
Elkhorn, NE 68022-4433
Phone (402) 934-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8087NEMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Panneton DDS PC CurrentSince May 25, 2025 Accepting new patients
Omaha Sleep Solutions CurrentSince May 25, 2025 Accepting new patients

Locations

18140 Burke St
Ste 100
Elkhorn, NE 68022
Phone (402) 205-1672

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1063205193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18140 BURKE ST STE 100",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680224433",
            "telephone_number": "402-934-5200",
            "fax_number": "402-537-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18140 BURKE ST STE 100",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680224433",
            "telephone_number": "402-934-5200",
            "fax_number": "402-537-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVRIES",
        "first_name": "BAYLOR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "8087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.