Teryn Sedillo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

7318 Issued in NE

Practice address

5884 High Pasture Dr
Fort Calhoun, NE 68023-8201

Phone

(913) 704-8012

NPI assigned

Feb 13, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Sedillo Mobile DDS NE LLC

  • Dental Clinic/Center
  • Fort Calhoun, NE
  • NPI 1366213258
  NPD
• Quality Living Inc

  dba Qli Physician's Clinic

  • Physical Medicine & Rehabilitation Physician
  • Omaha, NE
  • NPI 1710458237
  NPD (past)

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1346664141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5884 HIGH PASTURE DR",
            "city": "FORT CALHOUN",
            "state": "NE",
            "postal_code": "680238201",
            "telephone_number": "913-704-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5884 HIGH PASTURE DR",
            "city": "FORT CALHOUN",
            "state": "NE",
            "postal_code": "680238201",
            "telephone_number": "913-704-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDILLO",
        "first_name": "TERYN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-13",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Lee Preister Sr.
• Jessica Preister
• Kathleen Elizabeth Preister
• Veleka Prunty, M.S., SLP
• Sedillo Mobile DDS NE LLC
• TD Nurse Practitioner Services, LLC
• Wilcox Properties of Fort Calhoun, LLC (Autumn Pointe)

• Dentist in Fort Calhoun, NE
• Providers in Fort Calhoun, NE by specialty
• Dentist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.