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General NPI Number Information
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NPI Number | 1588581300
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Entity Type | Organization
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Legal Business Name | STOIC DENTAL LLC
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 5801 S 58TH ST STE AA
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City | LINCOLN
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State | NE
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Zip | 68516-6405
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Country | US
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Telephone | 402-259-0206
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Fax | 402-259-0325
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Provider Business Mailing Address
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Address Line | 5801 S 58TH ST STE AA
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City | LINCOLN
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State | NE
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Zip | 68516-6405
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Country | US
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Telephone | 402-259-0206
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Fax | 402-259-0325
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHANE GALEN SUDMAN
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Credential | D.D.S.
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Telephone | 773-597-8863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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