Provider Demographics
NPI:1952363533
Name:DINUCCI, KENT R (DPM)
Entity Type:Individual
Prefix:MR
First Name:KENT
Middle Name:R
Last Name:DINUCCI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8625 Q STREET
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-3673
Mailing Address - Country:US
Mailing Address - Phone:402-331-0221
Mailing Address - Fax:402-331-9903
Practice Address - Street 1:8625 Q STREET
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-3673
Practice Address - Country:US
Practice Address - Phone:402-331-0221
Practice Address - Fax:402-331-9903
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE300213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00282104OtherRAILROAD MEDICARE
249313OtherMIDLANDS CHOICE
NE10025339700Medicaid
NE02569OtherBCBS
NE02569OtherBCBS
249313OtherMIDLANDS CHOICE