MEDICARE: LINDGREN DENTAL, P.C.

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
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1619711090
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDGREN DENTAL, P.C.

Provider Business Mailing Address
First Line	:	6811 S 167TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68135-5401
Country	:	US
Telephone Number	:	402-861-6565
Fax Number	:	402-861-4118

Provider Business Practice Location Address
First Line	:	6811 S 167TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68135-5401
Country	:	US
Telephone Number	:	402-861-6565
Fax Number	:	402-861-4118

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LARAMIE LINDGREN
Credential	:	DDS
Telephone Number	:	402-861-6565

Provider Enumeration Date	:	06/21/2024
Last Update Date	:	06/21/2024

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