NPIMap

Organization Active NPI

West Maple Dental Specialists

  • Pediatric Dentistry
  • Omaha, NE
National Provider Identifier
1437252053
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5942 Issued in NE
Legal business name
WEST MAPLE DENTAL SPECIALISTS
Practice address
14270 West Maple Rd
Omaha, NE 68164
Phone
(402) 491-3100
Fax
(402) 445-4094
NPI assigned
Sep 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Lourdes M Secola, DDSNPI 1598039257
Title
President
Phone
(402) 491-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 5942 NE Primary

Addresses

Primary practice location

14270 West Maple Rd
Omaha, NE 68164

Mailing address

14270 West Maple Rd
Omaha, NE 68164
Phone (402) 491-3100

Other identifiers 1

IdentifierTypeStateIssuer
10025250800MedicaidNE

National Provider Directory

National Provider Directory

Locations

14270 W Maple Rd
Omaha, NE 68164
Phone (402) 491-3100

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437252053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14270 WEST MAPLE RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68164",
            "telephone_number": "402-491-3100",
            "fax_number": "402-445-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14270 WEST MAPLE RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68164",
            "telephone_number": "402-491-3100",
            "fax_number": "402-445-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST MAPLE DENTAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SECOLA",
        "authorized_official_first_name": "LOURDES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-491-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NE",
            "license": "5942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025250800",
            "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 Aug 22, 2020; 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.