Healthcare Provider Details

I. General information

NPI: 1902352859
Provider Name (Legal Business Name): JENNIFER CARTER D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3272 SALT CREEK CIR
LINCOLN NE
68504-4759
US

IV. Provider business mailing address

3272 SALT CREEK CIR
LINCOLN NE
68504-4759
US

V. Phone/Fax

Practice location:
  • Phone: 402-476-1500
  • Fax:
Mailing address:
  • Phone: 402-476-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number7306
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: