Fender, Derek A

Fender, Derek A is an sole proprietor health care provider with primary practice located at 100 Indian Hills Drive Po Box 250, Macy NE 68039-0250. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Fender, Derek A can be contacted via phone (402) 837-5381.

Contact Information

Primary practice address
100 Indian Hills Drive Po Box 250 Macy NE 68039-0250
Fax: (402) 837-5271
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 5847 Nebraska

Profile Details

NPI number 1164539573
LBN Legal business name Fender, Derek A
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 23rd, 2006
Last updated Mar 17th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164539573 NPPES
Nebraska MEDICAID PENDING
Nebraska MEDICAID 47084147000
Nebraska Other 688400
Nebraska Other 7833

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