Healthcare Provider Details

I. General information

NPI: 1942133541
Provider Name (Legal Business Name): ALEX DYKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2917 PINE LAKE RD
LINCOLN NE
68516-6032
US

IV. Provider business mailing address

2917 PINE LAKE RD
LINCOLN NE
68516-6032
US

V. Phone/Fax

Practice location:
  • Phone: 402-466-9632
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8207
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: