Provider Demographics
NPI:1033150040
Name:MEYER, DEAN LEWIS (OD)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:LEWIS
Last Name:MEYER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 540544
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-0544
Mailing Address - Country:US
Mailing Address - Phone:402-333-7772
Mailing Address - Fax:402-333-9752
Practice Address - Street 1:12279 W. CENTER RD
Practice Address - Street 2:CRESTWOOD PLAZA
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3957
Practice Address - Country:US
Practice Address - Phone:402-333-7772
Practice Address - Fax:402-333-9752
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE879152W00000X
IAIA1752152W00000X
CACA7762152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
410006239OtherRR RET
NE470703794-01Medicaid
NE47070379400Medicaid
NE47070379400Medicaid
NE47070379400Medicaid
NET40330Medicare UPIN
410006239OtherRR RET