Healthcare Provider Details

I. General information

NPI: 1639505092
Provider Name (Legal Business Name): PATRICIA LYNN BRINKMAN RDH, MS, COM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA LYNN BRINKMAN-FALTER

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8911 WHISPERING WIND RD
LINCOLN NE
68512-9278
US

IV. Provider business mailing address

8911 WHISPERING WIND RD
LINCOLN NE
68512-9278
US

V. Phone/Fax

Practice location:
  • Phone: 402-759-2561
  • Fax:
Mailing address:
  • Phone: 402-759-2561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number613
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number175-C-12
License Number State
# 3
Primary TaxonomyY
Taxonomy Code125K00000X
TaxonomyAdvanced Practice Dental Therapist
License Number67
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: