Provider Demographics
NPI:1891591442
Name:TENONTO, DAGBEGNON GUSTAVE
Entity type:Individual
Prefix:
First Name:DAGBEGNON
Middle Name:GUSTAVE
Last Name:TENONTO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10541 SAHLER PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-3416
Mailing Address - Country:US
Mailing Address - Phone:319-320-8554
Mailing Address - Fax:
Practice Address - Street 1:9001 ARBOR ST STE 206
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2066
Practice Address - Country:US
Practice Address - Phone:402-712-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant