Healthcare Provider Details

I. General information

NPI: 1700719333
Provider Name (Legal Business Name): LUKE LAWRENCE ANDREASEN DDS
Entity Type: Individual
Gender: Male
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

19260 GOLD ST
OMAHA NE
68130-3040
US

IV. Provider business mailing address

19260 GOLD ST
OMAHA NE
68130-3040
US

V. Phone/Fax

Practice location:
  • Phone: 402-933-8005
  • Fax:
Mailing address:
  • Phone: 402-933-8005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8197
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: