Healthcare Provider Details

I. General information

NPI: 1639088925
Provider Name (Legal Business Name): PREMIER SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11704 W CENTER RD STE 110
OMAHA NE
68144-4327
US

IV. Provider business mailing address

11704 W CENTER RD STE 110
OMAHA NE
68144-4327
US

V. Phone/Fax

Practice location:
  • Phone: 402-658-1828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KENT DINUCCI
Title or Position: MEDICAL DIRECTOR
Credential: DPM
Phone: 402-350-2733