Provider Demographics
NPI:1194846808
Name:VIECELI, LYNNE MAREE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:MAREE
Last Name:VIECELI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5416 IZARD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-2145
Mailing Address - Country:US
Mailing Address - Phone:402-932-8784
Mailing Address - Fax:402-933-3019
Practice Address - Street 1:4101 GROVER ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-3826
Practice Address - Country:US
Practice Address - Phone:402-553-2988
Practice Address - Fax:402-933-3019
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE58351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice