# HEARTLAND ENDODONTIC SPECIALISTS, LLC

> 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:** 1871690842
- **Authorized official:** DR. LARRY JOHNSON ELLISON DDS (PARTNER)
- **Authorized official phone:** (402) 393-5050

## Contact information

- **Practice address:** 615 N 90TH ST, OMAHA, NE 68114-2821
- **Practice address phone:** (402) 393-5050
- **Practice address fax:** (402) 393-3401
- **Mailing address:** 615 N 90TH ST, OMAHA, NE 68114-2821
- **Mailing address phone:** (402) 393-5050
- **Mailing address fax:** (402) 393-3401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | NE | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 08/28/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 460446 | UNITED CONCORDIA | NE |