Provider Demographics
NPI:1588984389
Name:REDLINGER, TEALA DAWN (DDS)
Entity type:Individual
Prefix:
First Name:TEALA
Middle Name:DAWN
Last Name:REDLINGER
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 1:2212 S 64TH PLZ APT 332
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2837
Mailing Address - Country:US
Mailing Address - Phone:702-809-7625
Mailing Address - Fax:
Practice Address - Street 1:2503 S 140TH CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2315
Practice Address - Country:US
Practice Address - Phone:402-333-3151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE68721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice