Healthcare Provider Details

I. General information

NPI: 1336067776
Provider Name (Legal Business Name): PAPILLION PEDIATRIC DENTISTRY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 FORTUNE DR STE 400
PAPILLION NE
68046-3426
US

IV. Provider business mailing address

545 FORTUNE DR STE 400
PAPILLION NE
68046-3426
US

V. Phone/Fax

Practice location:
  • Phone: 402-502-1256
  • Fax:
Mailing address:
  • Phone: 402-502-1256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. JANE LAURA BENNETT
Title or Position: OWNER/ DENTIST
Credential: DDS
Phone: 402-502-1256