Provider Demographics
NPI:1114021201
Name:OLBERDING, LOUIS F (DDS)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:F
Last Name:OLBERDING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 PINE LAKE RD STE 115
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5427
Mailing Address - Country:US
Mailing Address - Phone:402-488-2325
Mailing Address - Fax:402-488-2763
Practice Address - Street 1:3901 PINE LAKE RD STE 115
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5427
Practice Address - Country:US
Practice Address - Phone:402-488-2325
Practice Address - Fax:402-488-2763
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6209122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE04539OtherBC/BS
NE10025004400Medicaid
1329995OtherUNITED CONCORDIA