Provider Demographics
NPI:1417117557
Name:MENDLIK, DAVID F (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:F
Last Name:MENDLIK
Suffix:
Gender:M
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 E GRANT STREET
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:NE
Mailing Address - Zip Code:68788-1814
Mailing Address - Country:US
Mailing Address - Phone:402-372-3864
Mailing Address - Fax:402-727-8896
Practice Address - Street 1:129 E GRANT STREET
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:NE
Practice Address - Zip Code:68788-1814
Practice Address - Country:US
Practice Address - Phone:402-372-3864
Practice Address - Fax:402-727-8896
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE127231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025278000Medicaid
NE10025278100OtherMEDICAID HEARING AID
NE099713OtherMEDICARE GROUP
NE10025278100OtherMEDICAID HEARING AID