Provider Demographics
NPI:1295826139
Name:RIES, BARBARA J (DDS, MS, PC)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:J
Last Name:RIES
Suffix:
Gender:F
Credentials:DDS, MS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 N 129TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-6107
Mailing Address - Country:US
Mailing Address - Phone:402-330-9564
Mailing Address - Fax:402-330-8539
Practice Address - Street 1:624 N 129TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-6107
Practice Address - Country:US
Practice Address - Phone:402-330-9564
Practice Address - Fax:402-330-8539
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE52221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENE5222Medicare UPIN