Family and Cosmetic Dentistry PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FAMILY AND COSMETIC DENTISTRY PC

Practice address

11836 Elm Street
Suite 1
Omaha, NE 68144-4439

Phone

(402) 334-8208

Fax

(402) 334-1106

NPI assigned

Dec 6, 2006

Last updated

Aug 1, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Timothy Ray Ellis, DDSNPI 1801143813

Title

President

Phone

(402) 334-8208

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, and the practitioner matching its NPPES authorized official.

• Timothy Ray Ellis, D.D.S

  • General Practice Dentistry
  • Omaha, NE
  • NPI 1801143813
  NPD (past) Authorized official

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343779200000",
    "number": "1194884296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12518 A STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444137",
            "telephone_number": "402-330-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11836 ELM STREET",
            "address_2": "SUITE 1",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444439",
            "telephone_number": "402-334-8208",
            "fax_number": "402-334-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY AND COSMETIC DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2012-08-01",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-334-8208",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell Wayne Fallin
• Maya Fallon
• Tahoua Curtys Prunelle Famien
• Families and Connections Collaborative Services
• Families and Connections Collaborativeservices LLC
• Family Connection Supportive Living Services
• Family Dental Associates (Rainbow Dental Center)
• Family Development Services LLC
• Family Dynamics
• Family Ear Nose & Throat Clinic PC

• General Practice Dentistry in Omaha, NE
• Providers in Omaha, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.