Susan Marie Niles

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5335 Issued in NE

Practice address

14707 California Street
Seville Square Office Building Suite 15
Omaha, NE 68154-1900

Phone

(402) 498-0777

Fax

(402) 498-0853

NPI assigned

Mar 14, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Susan M Niles Professional name

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)

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 and National Provider Directory roles.

• CT Dental Associates LLC

  • Dentist
  • Omaha, NE
  • NPI 1437075017
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1780717066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14707 CALIFORNIA STREET",
            "address_2": "SEVILLE SQUARE OFFICE BUILDING SUITE 15",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681541900",
            "telephone_number": "402-498-0777",
            "fax_number": "402-498-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14707 CALIFORNIA STREET",
            "address_2": "SEVILLE SQUARE OFFICE BUILDING SUITE 15",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681541900",
            "telephone_number": "402-498-0777",
            "fax_number": "402-498-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILES",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "5335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IN",
            "identifier": "470727849",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "NILES",
            "middle_name": "M",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Gilles Nikiema
• Wendesongde Lynette Nikiema
• Panagiotes Nikolaides, DPT
• Katelyn Ann Niksick, HIGH SCHOOL DIPLOMA
• Nil Sine Deo (A Place At Home Papillion)
• Deborah Nilius, MS CCC/SLP
• Gregory Scott Nilius, DC
• Thomas Theodore Nilles-Melchert, MD
• Jonathan Nilles, DO
• Robert Gerald Nilles, D.C.

• 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 Aug 1, 2023; 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.