Provider Demographics
NPI:1013219062
Name:NUNN, MARTHA ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:ELIZABETH
Last Name:NUNN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 41ST AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-2131
Mailing Address - Country:US
Mailing Address - Phone:402-562-7500
Mailing Address - Fax:402-564-0611
Practice Address - Street 1:4321 41ST AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-2131
Practice Address - Country:US
Practice Address - Phone:402-562-7500
Practice Address - Fax:402-564-0611
Is Sole Proprietor?:No
Enumeration Date:2010-11-24
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS46131223G0001X
NEDENTAL FACULTY 1161223G0001X
NE7805122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice