Provider Demographics
NPI:1275684110
Name:KENT, DEAN B (MS CCC-A)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:B
Last Name:KENT
Suffix:
Gender:M
Credentials:MS CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8313 CASS ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3529
Mailing Address - Country:US
Mailing Address - Phone:402-391-0811
Mailing Address - Fax:
Practice Address - Street 1:8313 CASS ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3529
Practice Address - Country:US
Practice Address - Phone:402-391-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE191237600000X
NE618237700000X
IA00842237700000X
SD366A237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0564252Medicaid
NE47-060527200Medicaid