Active NPI
Rita Mary Sundermann, R.D.H.
- Dental Hygienist
- Offutt AFB, NE
National Provider Identifier
1922072842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 03001
- Practice address
- 2501 Capehart Rd
Offutt a F B, NE 68113-1043 - Phone
- (402) 294-3211
- NPI assigned
- Feb 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 03001 | IA | Primary |
Addresses
Primary practice location
2501 Capehart Rd
Offutt a F B, NE 68113-1043
Mailing address
4030 N 156TH Ave
Omaha, NE 68116-2860
Phone (402) 740-9664
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03001 | IA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922072842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4030 N 156TH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681162860",
"telephone_number": "402-740-9664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 CAPEHART RD",
"city": "OFFUTT A F B",
"state": "NE",
"postal_code": "681131043",
"telephone_number": "402-294-3211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUNDERMANN",
"first_name": "RITA",
"middle_name": "MARY",
"name_prefix": "Ms.",
"credential": "R.D.H.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "IA",
"license": "03001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Offutt AFB, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.