Otten, John J

Otten, John J is an individual health care provider with primary practice located at 4014 Leavenworth St , Omaha NE 68105-1053. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Otten, John J can be contacted via phone (402) 559-5999.

Contact Information

Primary practice address
4014 Leavenworth St Omaha NE 68105-1053
Phone: (402) 559-5999
Fax: (402) 559-3499
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 019-023700 Illinois
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 021-001773 Illinois
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 30317 Nebraska

Profile Details

NPI number 1902930159
LBN Legal business name Otten, John J
Credentials M.D., D.D.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2007
Last updated Mar 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902930159 NPPES
Illinois Other 909830 MEDICARE PT10

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