Healthcare Provider Details

I. General information

NPI: 1255266763
Provider Name (Legal Business Name): JADYN R DODD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 S 48TH ST
LINCOLN NE
68516-4199
US

IV. Provider business mailing address

1918 TEAL CIR
LINCOLN NE
68506-6542
US

V. Phone/Fax

Practice location:
  • Phone: 402-474-4000
  • Fax:
Mailing address:
  • Phone: 402-432-2288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: