MEDICARE: CADE HUNZEKER, DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1326826967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CADE HUNZEKER, DDS

Provider Business Mailing Address
First Line	:	2430 S 179TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68130-2687
Country	:	US
Telephone Number	:	402-330-1131
Fax Number	:	402-991-6541

Provider Business Practice Location Address
First Line	:	2430 S 179TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68130-2687
Country	:	US
Telephone Number	:	402-330-1131
Fax Number	:	402-991-6541

Authorized Official
Title or Position	:	DENTAL OFFICE MANAGER
Name	:	DANNIELLE CHAVEZ
Credential	:
Telephone Number	:	402-330-1131

Provider Enumeration Date	:	09/15/2023
Last Update Date	:	09/19/2023

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