Christina Leigh Pruitt, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6890 Issued in NE

Practice address

5006 Underwood Ave
Omaha, NE 68132-2236

Phone

(402) 502-7000

NPI assigned

Apr 5, 2010

Last updated

Feb 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 1, 2017 through Feb 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1609191451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5006 UNDERWOOD AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681322236",
            "telephone_number": "402-502-7000",
            "fax_number": "402-502-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5006 UNDERWOOD AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681322236",
            "telephone_number": "402-502-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "CHRISTINA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Provision Eye Care LLC
• Jessica Prucha, PHARMD
• William Pruett, MD
• Ashlee Sue Pruis-Trapp, PLMHP
• Chase A Pruitt, DDS, MD
• Melissa Renee Pruitt, MS, LIMHP, LPC
• Tariq Pruitt
• Jessica Elaine Prusa Flores, M.D.
• Kathyrn Prusacki
• Thomas S Pruse, M.D.

• General Practice Dentistry in Omaha, NE
• Providers in Omaha, 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 Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.