Individual provider Active NPI

Tracy Tram, DDS

  • General Practice Dentistry
  • Omaha, NE
National Provider Identifier
1659847069
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD4891 Issued in NM
Practice address
4400 Emile St
Omaha, NE 68198-0600
Phone
(402) 559-6000
NPI assigned
Oct 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DD4891 NM Primary

Addresses

Primary practice location

4400 Emile St
Omaha, NE 68198-0600

Mailing address

1844 War Admiral Dr SE
Albuquerque, NM 87123-2292
Phone (505) 480-3357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DD4891NMMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1659847069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 WAR ADMIRAL DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871232292",
            "telephone_number": "505-480-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 EMILE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681980600",
            "telephone_number": "402-559-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAM",
        "first_name": "TRACY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD4891",
            "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 Oct 23, 2018; 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.