Healthcare Provider Details

I. General information

NPI: 1134045446
Provider Name (Legal Business Name): AMANDA RIBEIRO WOBIDO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4830 SAINT PAUL AVE
LINCOLN NE
68504-2661
US

IV. Provider business mailing address

4830 SAINT PAUL AVE
LINCOLN NE
68504-2661
US

V. Phone/Fax

Practice location:
  • Phone: 402-466-2211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8228
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: