Provider Demographics
NPI:1245038777
Name:RENO, EMMA CLAIRE (DDS)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:CLAIRE
Last Name:RENO
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2522 W 64TH ST
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:KS
Mailing Address - Zip Code:66208-1912
Mailing Address - Country:US
Mailing Address - Phone:913-486-0011
Mailing Address - Fax:
Practice Address - Street 1:2109 CUMING ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-4325
Practice Address - Country:US
Practice Address - Phone:402-280-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOTBD1223G0001X, 122300000X
KSTBD1223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice