Dudzinski Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

5481 Issued in NE

Legal business name

DUDZINSKI DENTAL PC

Practice address

17404 Burke St
Omaha, NE 68118-2239

Phone

(402) 493-2112

Fax

(402) 493-8399

NPI assigned

Aug 25, 2014

Organization subpart

Yes

Parent organization

STOP DECAY PCAs reported in NPPES

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

Authorized official

Name

Darlene King

Title

Practice Manager

Phone

(402) 341-5306

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• New Image Dentistry at Village Pointe Doing business as

Tax ID family

Dudzinski Dental PC3 organizations share this tax ID, including this one

Part of

Stop Decay PC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Dudzinski Dental Corp.

  • General Practice Dentistry
  • Omaha, NE
  • NPI 1962795179
  NPD tax ID
• Dudzinski Dental PC

  • Dental Clinic/Center
  • Omaha, NE
  • NPI 1457984817
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Stop Decay PC

  • General Practice Dentistry
  • Omaha, NE
  • NPI 1316159403
  NPPES parent name

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1831599158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 VINTON ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681081921",
            "telephone_number": "402-341-5306",
            "fax_number": "402-346-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17404 BURKE ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681182239",
            "telephone_number": "402-493-2112",
            "fax_number": "402-493-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUDZINSKI DENTAL PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STOP DECAY PC",
        "enumeration_date": "2014-08-25",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "402-341-5306"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NE",
            "license": "5481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598992026",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47064716913",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Image Dentistry at Village Pointe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amber Elizabeth Duda, DO
• Bridgette Dudley
• Michele L Dudley, MS, LMHP, LPC
• Dudzinski Dental Corp.
• Dudzinski Dental PC
• Bernard Paul Dudzinski, DDS
• Colin Blair Dudzinski, DDS
• Jordan Dudzinski, D.D.S.
• Logan T Dudzinski, D.D.S.
• Austin Duerksen, PA-C

• Dentist in Omaha, NE
• Providers in Omaha, NE by specialty
• Dentist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.