Audrey Aden, DDS

Individual provider Active NPI Dentist · Gothenburg, NE

NPI 1467802116 · NPPES record last updated Jun 14, 2016

Key facts

NPI
1467802116
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
7314 (NE)
Practice address
513 10TH St
Gothenburg, NE 69138-1925
Phone
(308) 537-7195
NPI assigned
Jun 14, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7314NEMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7314 NE Yes

Addresses

Primary practice location

513 10TH St
Gothenburg, NE 69138-1925

Mailing address

513 10TH St
Gothenburg, NE 69138-1925
Phone (308) 537-7195

Other providers in Gothenburg, NE

All providers in Gothenburg, NE · Dentist in Nebraska

Sources for this page

Verify at the official NPI Registry.