Healthcare Provider Details

I. General information

NPI: 1780634568
Provider Name (Legal Business Name): TODD DALE SEKUNDIAK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 N 192ND ST
ELKHORN NE
68022-5363
US

IV. Provider business mailing address

8005 FARNAM DR STE 305
OMAHA NE
68114-3426
US

V. Phone/Fax

Practice location:
  • Phone: 402-390-4111
  • Fax: 402-390-4115
Mailing address:
  • Phone: 402-390-4111
  • Fax: 402-390-4115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number291029
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberC152157
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number14963
License Number StateND
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number22110
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: