Active NPI
Stacey Wells, RDH
- Dental Hygienist
- Omaha, NE
National Provider Identifier
1174761068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 1587
- Practice address
- 7975 L St
Suite a
Omaha, NE 68127-1731 - Phone
- (402) 339-3187
- Fax
- (402) 339-3914
- NPI assigned
- Jan 30, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 1587 | NE | Primary |
Addresses
Primary practice location
7975 L St
Suite a
Omaha, NE 68127-1731
Mailing address
7975 L Street
Suite a
Omaha, NE 68127
Phone (402) 339-3187
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025450000 | Medicaid | NE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1587 | NE | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233273600000",
"number": "1174761068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7975 L STREET",
"address_2": "SUITE A",
"city": "OMAHA",
"state": "NE",
"postal_code": "68127",
"telephone_number": "402-339-3187",
"fax_number": "402-339-3914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7975 L ST",
"address_2": "SUITE A",
"city": "OMAHA",
"state": "NE",
"postal_code": "681271731",
"telephone_number": "402-339-3187",
"fax_number": "402-339-3914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "STACEY",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-30",
"last_updated": "2009-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NE",
"license": "1587",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025450000",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.