Chidren'S Dentistry of South Omaha, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CHIDREN'S DENTISTRY OF SOUTH OMAHA, LLC

Practice address

2424 Oak St
Omaha, NE 68105-3727

Phone

(402) 932-5553

Fax

(402) 932-5557

NPI assigned

Feb 23, 2012

Organization subpart

No

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

Authorized official

Name

Magdalena Evans

Title

Sr Credentialing Specialist

Phone

(720) 603-4800

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacob William Gowans, D.M.D.

  • General Practice Dentistry
  • Omaha, NE
  • NPI 1801179627
  NPD (past)

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1134493083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 OAK ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681053727",
            "telephone_number": "402-932-5553",
            "fax_number": "402-932-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 OAK ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681053727",
            "telephone_number": "402-932-5553",
            "fax_number": "402-932-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIDREN'S DENTISTRY OF SOUTH OMAHA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-23",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "MAGDALENA",
        "authorized_official_title_or_position": "SR CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "720-603-4800"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saw CHI CHI
• Adam Stephen Chick, M.D.
• Kassandra Chick, APRN-NP
• Thomas Chick
• Andrew Chida, PA-C
• Alizabeth Chieng
• Prince Joel Chigbundu
• Vasanta Chigurupati
• Child and Family Psychiatric Specialists LLC
• Child Saving Institute

• Pediatric Dentistry in Omaha, NE
• Providers in Omaha, NE by specialty
• Pediatric Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.