Healthcare Provider Details

I. General information

NPI: 1669036042
Provider Name (Legal Business Name): NIA JONES ORTHODONTICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2019
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14707 CALIFORNIA ST STE 8
OMAHA NE
68154-1900
US

IV. Provider business mailing address

14707 CALIFORNIA ST STE 8
OMAHA NE
68154-1900
US

V. Phone/Fax

Practice location:
  • Phone: 402-498-5800
  • Fax: 402-492-9031
Mailing address:
  • Phone: 402-498-5800
  • Fax: 402-492-9031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTONIA JONES
Title or Position: PRESIDENT
Credential: DDS,MS
Phone: 402-498-5800