Provider Demographics
NPI:1417652595
Name:MURPHREE, JESSICA KRISTINA (DMD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:KRISTINA
Last Name:MURPHREE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3511 S 96TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3731
Mailing Address - Country:US
Mailing Address - Phone:402-682-1843
Mailing Address - Fax:
Practice Address - Street 1:4400 EMILE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-0600
Practice Address - Country:US
Practice Address - Phone:402-552-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NE7957122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program