Provider Demographics
NPI:1265481097
Name:SCOTT, REBECCA FRICKE (DDS)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:FRICKE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:MICHELLE
Other - Last Name:FRICKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6040 VILLAGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6640
Mailing Address - Country:US
Mailing Address - Phone:402-420-2222
Mailing Address - Fax:402-420-7045
Practice Address - Street 1:6040 VILLAGE DRIVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516
Practice Address - Country:US
Practice Address - Phone:402-420-2222
Practice Address - Fax:402-420-7045
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE63341223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry