Provider Demographics
NPI:1215004585
Name:STALLINGS, ROBERT GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GEORGE
Last Name:STALLINGS
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 1:7210 WHITESTONE CIR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1767
Mailing Address - Country:US
Mailing Address - Phone:402-483-6572
Mailing Address - Fax:
Practice Address - Street 1:5000 CENTRAL PARK DR
Practice Address - Street 2:SUITE 201
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-3465
Practice Address - Country:US
Practice Address - Phone:402-467-5432
Practice Address - Fax:402-467-5543
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE45991223G0001X
AZ23041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE86033912600Medicare ID - Type Unspecified