Surf'S Up Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SURF'S UP PEDIATRIC DENTISTRY

Practice address

10350 S. Terrance
Papillion, NE 68133

Phone

(435) 890-2295

NPI assigned

Feb 17, 2022

Organization subpart

No

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

Authorized official

Name

Bryce Cushing

Title

Owner/Ceo

Phone

(435) 890-2295

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645142400000",
    "number": "1104571249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 S. TERRANCE",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "68133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10350 S. TERRANCE",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "68133",
            "telephone_number": "435-890-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURF'S UP PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A",
        "authorized_official_last_name": "CUSHING",
        "authorized_official_first_name": "BRYCE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "435-890-2295"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaela Renae Stubbs
• Timothy James Stuttzman
• Superior Dental Health - Papillion
• Brielle L Suponchick, M.S. CF-SLP
• Anna Carolyn Suppes
• Christine M Svoboda, PA-C
• Jamie Marie Swan-Kellerman
• Kelsey Swan, PT, DPT
• Dana Swanson
• June Swiercek

• Pediatric Dentistry in Papillion, NE
• Providers in Papillion, NE by specialty
• Pediatric Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.