Organization Active NPI

Kimberly J Polley DDS, LLC

  • Dentist
  • Omaha, NE
National Provider Identifier
1558280164
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
KIMBERLY J POLLEY DDS, LLC
Practice address
1941 S 42ND St Ste 310
Omaha, NE 68105-2959
Phone
(402) 345-7800
Fax
(402) 345-7508
NPI assigned
Jul 15, 2026
Last updated
Jul 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Authorized official

Name
Dr. Kimberly Jacqueline Polley
Title
Owner/Dentist
Phone
(402) 345-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

1941 S 42ND St Ste 310
Omaha, NE 68105-2959

Mailing address

2720 N 182ND St
Elkhorn, NE 68022-1599
Phone (402) 345-7800

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1784073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784073600000",
    "number": "1558280164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 N 182ND ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680221599",
            "telephone_number": "402-345-7800",
            "fax_number": "402-345-7508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 S 42ND ST STE 310",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681052959",
            "telephone_number": "402-345-7800",
            "fax_number": "402-345-7508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY J POLLEY DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-15",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A",
        "authorized_official_last_name": "POLLEY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "402-345-7800",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 15, 2026; 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.