Individual provider Active NPI

Tomasz Czechura

  • Oral and Maxillofacial Surgery (Dentist)
  • Lincoln, NE
National Provider Identifier
1023544467
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
7696 Issued in NE
Practice address
2600 S 56TH St Ste a
Lincoln, NE 68506-3745
Phone
(402) 327-9400
NPI assigned
May 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 7696 NE Primary

Addresses

Primary practice location

2600 S 56TH St Ste a
Lincoln, NE 68506-3745

Mailing address

9303 Swan Creek Rd
Lincoln, NE 68520-1498
Phone (224) 305-0096

Other practice location 1

1211 21st Ave S
Suite 332, MAB
Nashville, TN 37212-2717
Phone (615) 343-9404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170926003952 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7911271150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
David J Rallis DDS MD Oral and Maxillofacial Surgery, PC Oral and Maxillofacial Surgery CurrentSince Aug 1, 2021 Accepting new patients

Locations

2600 S 56th St
Ste A
Lincoln, NE 68506
Phone (402) 327-9400

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1023544467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9303 SWAN CREEK RD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685201498",
            "telephone_number": "224-305-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 S 56TH ST STE A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685063745",
            "telephone_number": "402-327-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1211 21st Ave S",
            "address_2": "Suite 332, MAB",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372122717",
            "country_code": "US",
            "telephone_number": "615-343-9404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CZECHURA",
        "first_name": "TOMASZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-04",
        "last_updated": "2021-07-28",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NE",
            "license": "7696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.