Organization · Type 2 NPI

Stark and Johnson LLC

Pediatric Dentistry · Lincoln, NE

NPI number 1407105299 Active

Practice location

4301 S 80th St, Suite A
Lincoln, NE 68516-4404

Fax (402) 476-4305

Specialties and licenses

Taxonomy	Code	License
Pediatric Dentistry Primary	1223P0221X	None listed

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.

Other pediatric dentistry providers in Lincoln

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NPI record

NPI: 1407105299
Entity type: Organization (Type 2)
Issued: Sep 7, 2012
Last updated: Jan 12, 2022
Status: Active
Subpart: Yes of Stark and Johnson, LLC

Other names

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Lincoln Pediatric Dentistry · doing business as

Authorized official

Jenni K Wall
Insurance and Billing Manager
(402) 476-1500

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1407105299

Stark and Johnson LLC's National Provider Identifier is 1407105299, issued on Sep 7, 2012. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Lincoln, NE. The record was last updated on Jan 12, 2022.