The Orthodontists at Hillsborough

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

THE ORTHODONTISTS AT HILLSBOROUGH

Practice address

13808 W Maple Rd Ste 104
Omaha, NE 68164-6231

Phone

(402) 493-2268

Fax

(402) 905-0372

NPI assigned

Feb 17, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Kelly Marie Welch Fidone

Title

Office Manager

Phone

(402) 493-2268

Specialties & licenses 1

Addresses

Other names 1

• Greg Samuelson DDS MSD Former legal business name

Locations

Practitioners 1

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

• Nicholas Samuelson, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Omaha, NE
  • NPI 1538685698

  Orthodontics and Dentofacial Orthopedics

  NPD (past)

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1629601877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13808 W MAPLE RD STE 104",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681646231",
            "telephone_number": "402-493-2268",
            "fax_number": "402-905-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13808 W MAPLE RD STE 104",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681646231",
            "telephone_number": "402-493-2268",
            "fax_number": "402-905-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ORTHODONTISTS AT HILLSBOROUGH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "WELCH FIDONE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "402-493-2268",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greg Samuelson DDS MSD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• The Rehabilitation Center of Omaha, LLC
• The Salvation Army

• All providers in Omaha, NE
• Orthodontics and Dentofacial Orthopedics Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.