Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 4184 | NE |
NPI | 1033108279 |
---|---|
Provider Name | Dr. Dennis D Weiss |
First Address | Omaha, NE 68144-4486 |
Second Address | Omaha, NE 68144-4486 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
468651 | UNITED CONCORDIA INS (01) | NE |
470593761-01 | (05) | NE |
6203 | BC/BS INS (01) | NE |