Provider Demographics
NPI:1821576448
Name:CHOLEWA, RILEY (DDS)
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:
Last Name:CHOLEWA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-2841
Mailing Address - Country:US
Mailing Address - Phone:515-577-7048
Mailing Address - Fax:
Practice Address - Street 1:1105 HOWARD ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-2841
Practice Address - Country:US
Practice Address - Phone:515-577-7048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE75051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice