MEDICARE: FARRAH LYNN PLATE 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	6546	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932271491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARRAH LYNN PLATE DDS

Provider Business Mailing Address
First Line	:	9635 KOI ROCK DR
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68526-9678
Country	:	US
Telephone Number	:	402-499-0624
Fax Number	:	402-313-4380

Provider Business Practice Location Address
First Line	:	9635 KOI ROCK DR
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68526-9678
Country	:	US
Telephone Number	:	402-499-0624
Fax Number	:	402-313-4380

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	02/03/2024

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