Provider Demographics
NPI:1861559601
Name:KUMMER, SONYA LEIGH (DDS)
Entity type:Individual
Prefix:DR
First Name:SONYA
Middle Name:LEIGH
Last Name:KUMMER
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 1:162 BUTTERNUT LN
Mailing Address - Street 2:
Mailing Address - City:NEBRASKA CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68410-1136
Mailing Address - Country:US
Mailing Address - Phone:402-873-3111
Mailing Address - Fax:
Practice Address - Street 1:162 BUTTERNUT LN
Practice Address - Street 2:
Practice Address - City:NEBRASKA CITY
Practice Address - State:NE
Practice Address - Zip Code:68410-1136
Practice Address - Country:US
Practice Address - Phone:402-873-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5514122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE07958OtherBLUE CROSS BLUE SHIELD
NE46048160800Medicaid