Willow Dental Bellevue, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WILLOW DENTAL BELLEVUE, LLC

Practice address

7511 S 36TH St
Bellevue, NE 68147-1244

Phone

(402) 733-2281

Fax

(918) 235-9079

NPI assigned

Nov 22, 2023

Organization subpart

No

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

Authorized official

Name

Creed Cardon

Title

Owner

Phone

(918) 998-0996

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1700611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1366217051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TER STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619",
            "telephone_number": "918-998-0996",
            "fax_number": "918-235-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7511 S 36TH ST",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681471244",
            "telephone_number": "402-733-2281",
            "fax_number": "918-235-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW DENTAL BELLEVUE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-22",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "CARDON",
        "authorized_official_first_name": "CREED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-998-0996"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Lee Williams
• Marissa Marie Williams
• Muhammad A Williams
• Nadeizia Williams
• Nikola Williams
• James Wilmes
• Cheryl A Wilson
• Treshanna Wilson
• Krista Winter, MPH, BSN, RN
• Sevidzem Wirba Aisha

• General Practice Dentistry in Bellevue, NE
• Providers in Bellevue, 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 Nov 22, 2023; 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.