LINCOLN PEDIATRIC DENTISTRY (NPI# 1407105299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407105299 |
| Entity Type | Organization |
| Organization Name | LINCOLN PEDIATRIC DENTISTRY |
| Practice Address |
4301 S 80th St Suite A Lincoln NE 68516-4404 |
| Practice Telephone | 4024764301 |
| Practice Fax Number | 4024764305 |
| Mailing Telephone | 4024764301 |
| Mailing Fax Number | 4024764305 |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2013-07-02 |
| Authorized Official Name | DR. HEIDI J STARK (OWNER/OPERATOR) |
| Authorized Official Telephone | 4024761500 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
6838 | NE | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
6901 | NE | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
6881 | NE | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
6310 | NE | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437545829 | Lincoln Pediatric Dentistry | Exclusive Provider Organization | 25 South Mountain Rd., Lincoln, NH 03251 | 2015-04-13 |
| 1013219633 | Lincoln Pediatric Dentistry | Dentist | 3272 Salt Creek Cir, Suite A, Lincoln, NE 68504-4759 | 2010-12-02 |
| Street Address |
4301 S 80TH ST SUITE A |
| City | LINCOLN |
| State | NE |
| Zip Code | 68516-4404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295380988 | Link To Communication LLC | Speech-Language Pathologist | 5760 S 86th, Ste 2, Lincoln, NE 68516 | 2019-08-08 |
| 1780249011 | Boever Family Eyecare | Optometrist | 5801 Hidcote Dr Suite 101, Lincoln, NE 68516 | 2019-05-02 |
| 1922571462 | Lincoln Countryhouse II LLC | Assisted Living Facility | 6616 S 84th Street, Lincoln, NE 68516 | 2019-01-08 |
| 1508352808 | Kristin Marie Butterfield | Nurse Practitioner | 7655 Archer Place, Lincoln, NE 68516 | 2018-07-10 |
| 1679067839 | Beau D Bryant | Chiropractor | 5800 Hidcote Drive Suite 102, Lincoln, NE 68516 | 2018-06-20 |
| 1730688714 | Kathleen Morgan | Registered Nurse | 611 0 S 41st, Lincoln, NE 68516 | 2018-02-06 |
| 1689195695 | Laura Bokemper | Optometrist | 8201 S 40th St., Lincoln, NE 68516 | 2017-06-29 |
| 1346777562 | Kenneth Bradley Luedke | Counselor | 4706 South 48th St, Lincoln, NE 68516 | 2017-05-18 |
| 1154774669 | Jacob Tucker | Chiropractor | 7011 Kentwell Ln, Suite 200, Lincoln, NE 68516 | 2016-07-20 |
| 1699100214 | Tabitha Inc | Skilled Nursing Facility | 6120 South 34th Street, Lincoln, NE 68516 | 2013-09-13 |
| Find all providers in zip 68516 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992295612 | S.y.y Jang Dds Corp | Dentist | 731 Sterling Pkwy Ste 100c, Lincoln, CA 95648-7307 | 2018-05-17 |
| 1669976684 | M. Kucera, Dds, Inc. | Dentist | 150 Gateway Dr Ste 101, Lincoln, CA 95648-3316 | 2018-03-23 |
| 1083135545 | Roy S Burkhalter IIi | Dentist | 4000 East Campus Loop, Lincoln, NE 68583-0740 | 2017-07-05 |
| 1417399502 | Tavallaei Dmd Corp | Dentist | 731 Sterling Pkwy, Suite 100, Lincoln, CA 95648-7306 | 2013-07-18 |
| 1386984441 | Gregory Fought Dds PC | Dentist | 8600 Executive Woods Dr, Suite 100, Lincoln, NE 68512-9301 | 2013-02-26 |
| 1568504272 | Cynthia M Chan | Dentist | 3131 O St, Lincoln, NE 68510-1534 | 2007-02-12 |
| 1457400681 | South Lincoln Pediatric Dentistry LLC | Dentist | 6030 Village Dr, Suite 100, Lincoln, NE 68516 | 2007-01-09 |
| 1427113240 | Mary Virginia Osenbaugh | Dentist | 4630 Antelope Creek Rd, Suite 140, Lincoln, NE 68506-5592 | 2006-12-22 |
| 1003975640 | Tom J Milius | Dentist | 2621 S 70th St, Ste A, Lincoln, NE 68506-2911 | 2006-12-08 |
| 1104913581 | Kristin K Kohler | Dentist | 1660 S 70th St, Suite 200, Lincoln, NE 68506-1570 | 2006-10-06 |
| Find all providers in LINCOLN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.