Healthcare Provider Details

I. General information

NPI: 1558336115
Provider Name (Legal Business Name): NAGAMANI NARAYANA DMD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40TH AND HOLDREGE, UNMC COLLEGE OF DENTISTRY
LINCOLN NE
68583-0740
US

IV. Provider business mailing address

PO BOX 830740 40TH AND HOLDREGE
LINCOLN NE
68583-0740
US

V. Phone/Fax

Practice location:
  • Phone: 402-472-1355
  • Fax: 402-472-2551
Mailing address:
  • Phone: 402-472-1355
  • Fax: 402-472-2551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number6589
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: