Provider Demographics
NPI:1093060519
Name:SUAREZ, JESSICA FRANCES (DDS)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:FRANCES
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:FRANCES
Other - Last Name:WILBERDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:14826 FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-1465
Mailing Address - Country:US
Mailing Address - Phone:402-213-2407
Mailing Address - Fax:
Practice Address - Street 1:11110 FORT ST STE 106
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-2183
Practice Address - Country:US
Practice Address - Phone:402-492-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7045122300000X
IA08927122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist