Healthcare Provider Details

I. General information

NPI: 1316322530
Provider Name (Legal Business Name): JENNA CAROLINE HUBACZ D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 E CAMPUS LOOP S
LINCOLN NE
68583-1530
US

IV. Provider business mailing address

4000 E CAMPUS LOOP S
LINCOLN NE
68583-1530
US

V. Phone/Fax

Practice location:
  • Phone: 402-472-1333
  • Fax:
Mailing address:
  • Phone: 402-472-1333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1857459
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDN1857459
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: