NPIMap

Organization Active NPI

Kelsey Periodontal Group, LLC

  • Dental Clinic/Center
  • Omaha, NE
National Provider Identifier
1831423177
Registry record updated Sep 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
6632 Issued in NE
Legal business name
KELSEY PERIODONTAL GROUP, LLC
Practice address
17785 Mason St
Suite 103
Omaha, NE 68118-3526
Phone
(402) 934-4745
Fax
(402) 934-4760
NPI assigned
Sep 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2009

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

Authorized official

Name
Dr. William Patrick Kelsey V, D.D.S., M.S.NPI 1730315714
Title
Owner
Phone
(402) 934-4745

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 6632 NE Primary

Addresses

Primary practice location

17785 Mason St
Suite 103
Omaha, NE 68118-3526

Mailing address

17785 Mason St
Suite 103
Omaha, NE 68118-3526
Phone (402) 934-4745

National Provider Directory

National Provider Directory

Locations

17785 Mason St
Ste 103
Omaha, NE 68118
Phone (402) 934-4745

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253232000000",
    "number": "1831423177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17785 MASON ST",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681183526",
            "telephone_number": "402-934-4745",
            "fax_number": "402-934-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17785 MASON ST",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681183526",
            "telephone_number": "402-934-4745",
            "fax_number": "402-934-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELSEY PERIODONTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-18",
        "last_updated": "2009-09-18",
        "status": "A",
        "authorized_official_last_name": "KELSEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-934-4745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "V",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NE",
            "license": "6632",
            "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 Sep 18, 2009; 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.