Nicholas Samuelson, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

7241 Issued in NE

Practice address

5118 N 156TH St
Omaha, NE 68116-3226

Phone

(402) 493-2268

NPI assigned

Aug 20, 2017

Last updated

Apr 12, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Orthodontists at Hillsborough

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Omaha, NE
  • NPI 1629601877
  NPD (past)

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

{
    "created_epoch": "1503187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1538685698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5118 N 156TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681163226",
            "telephone_number": "402-493-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5118 N 156TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681163226",
            "telephone_number": "402-493-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-20",
        "last_updated": "2023-04-12",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS-09473",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NE",
            "license": "7241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellyette G Samuelson, PHARMD
• Eric Michael Samuelson, MD
• Greg Stuart Samuelson, D.D.S. M.S.D.
• Jay D Samuelson, DDS
• Karl Samuelson, BSN
• Ryan Samuelson
• Alusine Samura
• Carrie Sue San Martin, RN
• Moo Moo San
• Fatimata Sana

• Orthodontics and Dentofacial Orthopedics Dentistry in Omaha, NE
• Providers in Omaha, NE by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.