Provider Demographics
NPI:1114008943
Name:ZYSSET, MONTE K (DDS)
Entity type:Individual
Prefix:DR
First Name:MONTE
Middle Name:K
Last Name:ZYSSET
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 1:7555 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:402-423-7171
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:402-423-7171
Practice Address - Fax:402-423-7274
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE62031223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
7806OtherBCBS
NE47083316300Medicaid
7806OtherBCBS