Provider Demographics
NPI:1730222043
Name:ZYSSET PC
Entity type:Organization
Organization Name:ZYSSET PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED ORAL AND MAXILLOFAC
Authorized Official - Prefix:
Authorized Official - First Name:MONTE
Authorized Official - Middle Name:K
Authorized Official - Last Name:ZYSSET
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-423-7171
Mailing Address - Street 1:7555 S 57TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6663
Mailing Address - Country:US
Mailing Address - Phone:402-427-7171
Mailing Address - Fax:402-423-7274
Practice Address - Street 1:7555 S 57TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6663
Practice Address - Country:US
Practice Address - Phone:402-427-7171
Practice Address - Fax:402-423-7274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6203204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE=========00Medicaid