Provider Demographics
NPI:1619032570
Name:MAIXNER, DAVID ANTHONY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ANTHONY
Last Name:MAIXNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13520 CALIFORNIA ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-5253
Mailing Address - Country:US
Mailing Address - Phone:402-398-9887
Mailing Address - Fax:402-384-8428
Practice Address - Street 1:13520 CALIFORNIA ST
Practice Address - Street 2:SUITE 220
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-5253
Practice Address - Country:US
Practice Address - Phone:402-398-9887
Practice Address - Fax:402-384-8428
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE60341223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics