Provider Demographics
NPI:1225480676
Name:MCCOY, HEIDI JEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:JEAN
Last Name:MCCOY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:JEAN
Other - Last Name:DAMMAST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2110 TOWNE CENTRE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2110 TOWNE CENTRE DRIVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123
Practice Address - Country:US
Practice Address - Phone:402-559-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7301122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist