Provider Demographics
NPI:1417487950
Name:HEY, STACY (DMD)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:
Last Name:HEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:
Other - Last Name:GIBREAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:302 W PHILLIP AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5248
Mailing Address - Country:US
Mailing Address - Phone:402-371-8000
Mailing Address - Fax:402-371-0971
Practice Address - Street 1:302 W PHILLIP AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5248
Practice Address - Country:US
Practice Address - Phone:402-371-8000
Practice Address - Fax:402-371-0971
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002037071223G0001X
NE74291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice