Provider Demographics
NPI:1679564082
Name:NEUHAUS, JOHN A (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:NEUHAUS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 N HOWARD AVE 106B
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4962
Mailing Address - Country:US
Mailing Address - Phone:308-384-4949
Mailing Address - Fax:
Practice Address - Street 1:908 N HOWARD AVE STE 106B
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3529
Practice Address - Country:US
Practice Address - Phone:308-384-4949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE64991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice