John J Otten, M.D., D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30317 Issued in NE

Practice address

4014 Leavenworth St
Omaha, NE 68105-1053

Phone

(402) 559-5999

Fax

(402) 559-3499

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• MC Sheets DDS, PC

  • Dental Clinic/Center
  • Omaha, NE
  • NPI 1427627843

  Oral and Maxillofacial Surgery

  NPD (past)
• Associated Oral and Maxillofacial Surgeons of Peoria, LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Peoria, IL
  • NPI 1154357291
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1902930159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 LEAVENWORTH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681051053",
            "telephone_number": "402-559-5999",
            "fax_number": "402-559-3499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2807 N Knoxville Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616042869",
            "country_code": "US",
            "telephone_number": "309-682-1213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTTEN",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "M.D., D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-023700",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "021-001773",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NE",
            "license": "30317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PT10",
            "identifier": "909830",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah L Ott, DMD
• Brandi M Otte, RN
• Jessica M Otte
• Mindy Ann Otte, MS, CCC-SLP
• Mary Otteman, PA
• Julie Anne Otten
• Julie S Otten, PT
• Erik Thor Otterberg, MD
• Angela Otterstein, MS, PLMHP
• Matt Ottis

• Oral and Maxillofacial Surgery (Dentist) in Omaha, NE
• Providers in Omaha, NE by specialty
• Oral and Maxillofacial Surgery (Dentist) in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.