Provider Demographics
NPI:1336211507
Name:BELITZ, JUDITH ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANN
Last Name:BELITZ
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 1:2420 SO 73 ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124
Mailing Address - Country:US
Mailing Address - Phone:402-393-8444
Mailing Address - Fax:402-343-9017
Practice Address - Street 1:2420 SO 73 ST
Practice Address - Street 2:SUITE 301
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124
Practice Address - Country:US
Practice Address - Phone:402-393-8444
Practice Address - Fax:402-343-9017
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2023-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5707122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist