REID C WYCOFF DDS NPI 1629052840

NPI Information

NPI: 1629052840
Provider Name: REID C WYCOFF, DDS
Classification: Dentist - 1223E0200X
Entity Type: Individual

Specialization: Endodontics

PECOS Registration: Yes

Address:
2811 N 90TH ST
OMAHA, NE
ZIP 68134
Phone: (402) 391-0459
Get Directions

Reid C Wycoff, DDS is an endodontics dentist in Omaha, NE. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. Reid C Wycoff, DDS NPI is 1629052840. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2811 N 90TH ST
OMAHA, NE
ZIP 68134-707
Phone: (402) 391-0459
Fax: (402) 384-8888

The NPI 1629052840 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 12/1/2005 and was last updated on 1/21/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223E0200X	Dentist	Endodontics	6583-15	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1767815	OTHER	NEBRASKA	UNITED CONCORDIA ID
2	47063287713	MEDICAID	NEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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