Basic Information
| Provider Information | |||||||||
| NPI: | 1184025777 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAY | ||||||||
| FirstName: | KATE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4920 S 30TH ST | ||||||||
| Address2: | STE 103 | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681071656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025028846 | ||||||||
| FaxNumber: | 4024016005 | ||||||||
| Practice Location | |||||||||
| Address1: | 4920 S 30TH ST | ||||||||
| Address2: | STE 103 | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681071656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025028846 | ||||||||
| FaxNumber: | 4024016005 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2014 | ||||||||
| LastUpdateDate: | 03/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 03/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 7168 | NE | N | Dental Providers | Dentist | General Practice | 1223G0001X | 09106 | IA | Y | Dental Providers | Dentist | General Practice |
No ID Information.