Provider Demographics
NPI:1396260139
Name:WELSH, JAIME (DDS)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:
Last Name:WELSH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JAIME
Other - Middle Name:
Other - Last Name:RAJCHEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1617 FARNAM ST
Mailing Address - Street 2:PO BOX 92
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-1374
Mailing Address - Country:US
Mailing Address - Phone:573-268-2968
Mailing Address - Fax:
Practice Address - Street 1:17110 LAKESIDE HILLS PLZ
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-5600
Practice Address - Country:US
Practice Address - Phone:718-963-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-12
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0603901223G0001X
390200000X
NE7674122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program