Individual provider Active NPI

Niranzena Panneer Selvam, M.D.S.

  • Oral and Maxillofacial Radiology Dentistry
  • Omaha, NE
National Provider Identifier
1518580042
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X
License
7889 Issued in NE
Practice address
2109 Cuming Street
Omaha, NE 68102
Phone
(804) 585-5189
NPI assigned
May 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36716 TX
Oral and Maxillofacial Radiology Dentistry 1223X0008X 7889 NE Primary

Addresses

Primary practice location

2109 Cuming Street
Omaha, NE 68102

Mailing address

5325 S111Th Plaza Apt 201
Omaha, NE 68137
Phone (804) 585-5189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250607000095 NE Order and Referring Only - DentistPractitioner - Dentist 4486164647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36716TXMDDentist
7889NEMDOral and Maxillofacial Radiology Dentist

NPI Registry JSON

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1518580042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 S111TH PLAZA APT 201",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68137",
            "telephone_number": "804-585-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 CUMING STREET",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68102",
            "telephone_number": "804-585-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNEER SELVAM",
        "first_name": "NIRANZENA",
        "credential": "M.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-19",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36716",
            "primary": false
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "NE",
            "license": "7889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.