Healthcare Provider Details

I. General information

NPI: 1811809759
Provider Name (Legal Business Name): MARETIS DOSEDLA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4540 SPENCER ST
OMAHA NE
68104-3737
US

IV. Provider business mailing address

204 GALVIN RD N
BELLEVUE NE
68005-4899
US

V. Phone/Fax

Practice location:
  • Phone: 402-813-7844
  • Fax:
Mailing address:
  • Phone: 402-639-7648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: