Andersen, John D
Andersen, John D is an individual health care provider with primary practice located at 13215 Birch St Suite 100, Omaha NE 68164-5431. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Andersen, John D can be contacted via phone (402) 390-0770.Contact Information
Primary practice address
13215 Birch St Suite 100
Omaha NE 68164-5431
Phone: (402) 390-0770
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 7220 | Iowa |
Profile Details
| NPI number | 1306940770 |
|---|---|
| LBN Legal business name | Andersen, John D |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 7th, 2006 |
| Last updated | Dec 22nd, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306940770 | NPPES |
| Iowa | MEDICAID | 0249052 |
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