Healthcare Provider Details
I. General information
NPI: 1558280164
Provider Name (Legal Business Name): KIMBERLY J POLLEY DDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1941 S 42ND ST STE 310
OMAHA NE
68105-2959
US
IV. Provider business mailing address
2720 N 182ND ST
ELKHORN NE
68022-1599
US
V. Phone/Fax
- Phone: 402-345-7800
- Fax: 402-345-7508
- Phone: 402-345-7800
- Fax: 402-345-7508
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KIMBERLY
JACQUELINE
POLLEY
Title or Position: OWNER/DENTIST
Credential:
Phone: 402-345-7800