Provider Demographics
NPI:1477928794
Name:WEBB ORTHODONTICS, LLP
Entity Type:Organization
Organization Name:WEBB ORTHODONTICS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMI
Authorized Official - Middle Name:JO
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:308-630-0670
Mailing Address - Street 1:820 W 42ND ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4709
Mailing Address - Country:US
Mailing Address - Phone:308-630-0670
Mailing Address - Fax:
Practice Address - Street 1:820 W 42ND ST STE 1100
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4709
Practice Address - Country:US
Practice Address - Phone:308-630-0670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-11
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE62811223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100251889-00Medicaid