JOHN J OTTEN M.D., D.D.S.
NPI 1902930159
Dentist - Oral and Maxillofacial Surgery in Omaha, NE

Q: What is John Otten's NPI number?

The NPI number for John Otten is 1902930159. It was assigned to this individual provider in the NPPES registry on March 16, 2007.

Q: What is John Otten's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: When was this NPI record last updated?

The NPPES record for John Otten was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 16, 2007PECOS Enrolled

4014 LEAVENWORTH ST, OMAHA, NE 68105(402) 559-5999(402) 559-3499 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2018, Feb 28, 2018 (2 updates tracked since 2018).

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About John J Otten M.d., D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN J OTTEN M.D., D.D.S. (NPI 1902930159) is an individual oral and maxillofacial surgery provider in Omaha, Nebraska, licensed in Nebraska (30317) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in Peoria.

NPPES Registry Identity

NPI1902930159

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameJOHN J OTTENCredential: M.D., D.D.S.

Location Address4014 LEAVENWORTH STOmaha, NE 68105-1053

Mailing Address988102 Nebraska Medical CtrOmaha, NE 68198-8102

Phone(402) 559-5999

Fax(402) 559-3499

Sole ProprietorNo

Enumeration DateMarch 16, 2007

Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration

✔ NPI 1902930159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

Licenses✔ Licensed in NE · 30317✔ Licensed in IL · 021-001773

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Also ListedDentist · General PracticeTaxonomy 1223G0001X · License 019-023700 (IL)

4014 LEAVENWORTH ST, Omaha, NE 68105

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Secondary Practice Location 1

Location 12807 N Knoxville AvePeoria, IL 61604-2869 · Phone (309) 682-1213

Other Identifiers 1

Other909830IL · Medicare Pt10

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John J Otten M.d., D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 68105 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.20 typical visit price

range $52.69 – $160.21

Typical copayment $20.30 (range $13.17 – $40.05)

Most-billed visit code 99203

Established Patient

$66.00 typical visit price

range $16.90 – $131.25

Typical copayment $16.50 (range $4.22 – $32.81)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SARAH LAND LONOWSKI MD, MBA

Student in an Organized Health Care Education/Training Program