Provider Demographics
NPI:1942304043
Name:JEFF F CHEREK DDS PC
Entity Type:Organization
Organization Name:JEFF F CHEREK DDS PC
Other - Org Name:CHEREK FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFRY
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:CHEREK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-861-6565
Mailing Address - Street 1:6811 S 167TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-5401
Mailing Address - Country:US
Mailing Address - Phone:402-861-6565
Mailing Address - Fax:402-861-4118
Practice Address - Street 1:6811 S 167TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-5401
Practice Address - Country:US
Practice Address - Phone:402-861-6565
Practice Address - Fax:402-861-4118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6066N1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid