Provider Demographics
NPI:1356526867
Name:LITTLE, JARED REED (DDS)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:REED
Last Name:LITTLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21518 PINEHURST AVE
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-2209
Mailing Address - Country:US
Mailing Address - Phone:406-240-2124
Mailing Address - Fax:
Practice Address - Street 1:2109 CUMING STREET OFFICE 335F
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68178-6624
Practice Address - Country:US
Practice Address - Phone:402-280-5990
Practice Address - Fax:402-280-5013
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2243122300000X
NE7413122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist