Healthcare Provider Details

I. General information

NPI: 1275523516
Provider Name (Legal Business Name): MELISSA JILL SVEEN D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 01/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 A STREET SUITE 103
LINCOLN NE
68510-4205
US

IV. Provider business mailing address

7001 A STREET SUITE 103
LINCOLN NE
68510-4205
US

V. Phone/Fax

Practice location:
  • Phone: 402-434-3367
  • Fax: 402-434-3368
Mailing address:
  • Phone: 402-434-3367
  • Fax: 402-434-3368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number5241
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: