Healthcare Provider Details

I. General information

NPI: 1295826139
Provider Name (Legal Business Name): BARBARA J RIES DDS, MS, PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 N 129TH ST SUITE 100
OMAHA NE
68154-6107
US

IV. Provider business mailing address

624 N 129TH ST SUITE 100
OMAHA NE
68154-6107
US

V. Phone/Fax

Practice location:
  • Phone: 402-330-9564
  • Fax: 402-330-8539
Mailing address:
  • Phone: 402-330-9564
  • Fax: 402-330-8539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberNE5222
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: