Provider Demographics
NPI:1083648232
Name:PAUL J. SHERIDAN, D.D.S. , P.C.
Entity Type:Organization
Organization Name:PAUL J. SHERIDAN, D.D.S. , P.C.
Other - Org Name:MILLARD HILLS DENTAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHERIDAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-895-2085
Mailing Address - Street 1:14202 Y ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2862
Mailing Address - Country:US
Mailing Address - Phone:402-895-2085
Mailing Address - Fax:402-895-3144
Practice Address - Street 1:14202 Y ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2862
Practice Address - Country:US
Practice Address - Phone:402-895-2085
Practice Address - Fax:402-895-3144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5912122300000X
NE4962122300000X
NE3780122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty