Healthcare Provider Details

I. General information

NPI: 1881170777
Provider Name (Legal Business Name): ALAINA MARIE ALLEN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2018
Last Update Date: 07/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 EAST CAMPUS LOOP SOUTH
LINCOLN NE
68583-0740
US

IV. Provider business mailing address

4241 HOLDREGE ST APT 15
LINCOLN NE
68503-1447
US

V. Phone/Fax

Practice location:
  • Phone: 402-472-1333
  • Fax:
Mailing address:
  • Phone: 712-592-0222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7489
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: