NPIMap

Organization Active NPI

Thomas O Rudersdorf LLC

  • Dentist
  • Bellevue, NE
National Provider Identifier
1972971125
Registry record updated Sep 4, 2015
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6609 Issued in NE
Legal business name
THOMAS O RUDERSDORF LLC
Practice address
11513 S 37TH St
Suite 3
Bellevue, NE 68123-5210
Phone
(402) 292-1200
NPI assigned
Sep 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2015

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

Authorized official

Name
Dr. Thomas O Rudersdorf
Title
Owner
Phone
(402) 292-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6609 NE Primary

Addresses

Primary practice location

11513 S 37TH St
Suite 3
Bellevue, NE 68123-5210

Mailing address

11513 S 37TH St
Suite 3
Bellevue, NE 68123-5210
Phone (402) 292-1200

National Provider Directory

National Provider Directory

Locations

11513 S 37th St
Ste 3
Bellevue, NE 68123
Phone (402) 292-1200

NPI Registry JSON

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

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441324800000",
    "number": "1972971125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11513 S 37TH ST",
            "address_2": "SUITE 3",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681235210",
            "telephone_number": "402-292-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11513 S 37TH ST",
            "address_2": "SUITE 3",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681235210",
            "telephone_number": "402-292-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS O RUDERSDORF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-04",
        "last_updated": "2015-09-04",
        "status": "A",
        "authorized_official_last_name": "RUDERSDORF",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-292-1200",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NE",
            "license": "6609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; 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.