MEDICARE: DR. NICHOLAS DEAN STOLZE 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
1	122300000X	Dentist	8090	NE

General Provider Information

NPI Number	:	1891688016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS DEAN STOLZE DDS

Provider Business Mailing Address
First Line	:	826 S 35TH ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68510-3415
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	630 N COTNER BLVD STE 203A
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68505-2326
Country	:	US
Telephone Number	:	402-466-1333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2025
Last Update Date	:	05/29/2025

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