Provider Demographics
NPI:1154319077
Name:MCCARTHY, EMILY R (DDS)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:R
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 N 140TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-6075
Mailing Address - Country:US
Mailing Address - Phone:402-498-8040
Mailing Address - Fax:402-753-9918
Practice Address - Street 1:1817 N BELL ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-3160
Practice Address - Country:US
Practice Address - Phone:402-727-9100
Practice Address - Fax:402-753-9918
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE61691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice