Healthcare Provider Details

I. General information

NPI: 1922501121
Provider Name (Legal Business Name): VARSHA KADYAN BDS, MDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2018
Last Update Date: 02/11/2024
Certification Date: 02/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12223 W GILES RD
LA VISTA NE
68128-5801
US

IV. Provider business mailing address

1323 S 211TH ST
ELKHORN NE
68022-2421
US

V. Phone/Fax

Practice location:
  • Phone: 531-867-4273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License Number7859
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License Number37953
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: