MEDICARE: DR. KENDRA KOZISEK DDS

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	122300000X	Dentist	8222	NE

General Provider Information

NPI Number	:	1962336172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENDRA KOZISEK DDS

Provider Business Mailing Address
First Line	:	343 N COTNER BLVD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68505-2315
Country	:	US
Telephone Number	:	402-466-1914
Fax Number	:	402-475-8741

Provider Business Practice Location Address
First Line	:	343 N COTNER BLVD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68505-2315
Country	:	US
Telephone Number	:	402-466-1914
Fax Number	:	402-475-8741

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

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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Directions to “ DR. KENDRA KOZISEK DDS” Practice Location

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