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PIONEER WOODS DENTAL LLC NPI 1912079781


NPI Information

NPI: 1912079781
Provider Name: PIONEER WOODS DENTAL LLC

Doing Business As: PIONEER WOODS DENTAL

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
4210 PIONEER WOODS DRIVE
SUITE D
LINCOLN, NE
ZIP 68506
Phone: (402) 484-6042
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PIONEER WOODS DENTAL LLC is a general practice dentist in Lincoln, NE. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. PIONEER WOODS DENTAL LLC NPI is 1912079781. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Pioneer Woods Dental.

The provider's business location address is:

4210 PIONEER WOODS DRIVE
SUITE D
LINCOLN, NE
ZIP 68506
Phone: (402) 484-6042
Fax: (402) 484-6043

The provider's authorized official is Edward Eugene Quincy .
The authorized official title is Manager and has the following contact phone number (402) 447-6042.

The enumeration date for this NPI number is 11/15/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice5876NEBRASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
110025209600MEDICAIDNEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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