# PARRA FAMILY DENTISTRY PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396814182
- **Authorized official:** MRS. JODENE EDMONDS (DENTAL MANAGER)
- **Authorized official phone:** (402) 731-5423

## Contact information

- **Practice address:** 5050 L STREET, OMAHA, NE 68117
- **Practice address phone:** (402) 731-5423
- **Practice address fax:** (402) 884-5955
- **Mailing address:** 5050 L STREET, OMAHA, NE 68117
- **Mailing address phone:** (402) 731-5423
- **Mailing address fax:** (402) 884-5955

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NE | — |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 09/04/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10025130200 | — | NE |
| 05 | — | 10025602000 | — | NE |