Provider Demographics
NPI:1225029754
Name:KUNASEK, MATTHEW JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JOSEPH
Last Name:KUNASEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 S 4TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SEWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68434
Mailing Address - Country:US
Mailing Address - Phone:402-643-2931
Mailing Address - Fax:402-643-4258
Practice Address - Street 1:306 S 4TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434
Practice Address - Country:US
Practice Address - Phone:402-643-2931
Practice Address - Fax:402-643-4258
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE64761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47077269513Medicaid
098472SEMedicare ID - Type Unspecified