IndividualActive
John Otten, M.D., D.D.S.
NPI 1902930159 · Oral and Maxillofacial Surgery (Dentist) · Omaha, NE
Provider details
- NPI number
- 1902930159
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- M.D., D.D.S.
- Sex
- Male
- Sole proprietor
- No
- License
- 019-023700 (IL)
Specialties & taxonomies
Dental Providers
Dental Providers
Dental Providers
Practice location
4014 Leavenworth St
Omaha, NE 68105-1053
Phone: (402) 559-5999
Fax: (402) 559-3499
Approximate (ZIP-level) locationGet directions
Mailing address
988102 Nebraska Medical Ctr
Omaha, NE 68198-8102
Additional practice locations (1)
- 2807 N Knoxville AvePeoria, IL 61604-2869Phone: (309) 682-1213
Registry dates
- Enumerated
- 2007-03-16
- Last updated
- 2018-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.