Individual provider Active NPI

Paul J Sheridan, D.D.S.

  • Prosthodontics
  • Omaha, NE
National Provider Identifier
1902909112
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
5912 Issued in NE
Practice address
14202 Y St
Omaha, NE 68137-2862
Phone
(402) 895-2085
Fax
(402) 895-3144
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5912 NE
Prosthodontics 1223P0700X 5912 NE Primary

Addresses

Primary practice location

14202 Y St
Omaha, NE 68137-2862

Mailing address

17410 Cinnamon Cir
Omaha, NE 68135-3203
Phone (402) 614-6221

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5912NEMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Paul J. Sheridan, D.D.S. , P.C. Past Accepting new patients
Millard Hills Dental Health Center LLC General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1902909112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17410 CINNAMON CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681353203",
            "telephone_number": "402-614-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14202 Y ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372862",
            "telephone_number": "402-895-2085",
            "fax_number": "402-895-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "5912",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NE",
            "license": "5912",
            "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 11, 2025; 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.