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NPI Code Detail

MEDICARE: DR. LINCOLN RICHARD PEARSON DDS

MEDICARE: DR. LINCOLN RICHARD PEARSON DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist7626NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17626OTHERNELICENSE

General Provider Information

NPI Number : 1255957270
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LINCOLN RICHARD PEARSON DDS
Provider Business Mailing Address
First Line : 1745 N 86TH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68505-3632
Country : US
Telephone Number : 402-489-8848
Fax Number : 402-489-8938
Provider Business Practice Location Address
First Line : 1745 N 86TH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68505-3632
Country : US
Telephone Number : 402-489-8848
Fax Number : 402-489-8938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2020
Last Update Date : 06/25/2020

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Directions to “ DR. LINCOLN RICHARD PEARSON DDS” Practice Location

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