MEDICARE: MATTHEW C DENNIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1487822268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW C DENNIS

Provider Business Mailing Address
First Line	:	3320 N 125TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68164-4285
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3320 N 125TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68164-4285
Country	:	US
Telephone Number	:	402-281-1626
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	12/11/2025

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Directions to “ MATTHEW C DENNIS ” Practice Location

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