Provider Demographics
NPI:1508839341
Name:GIANNINI, PETER JOHN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOHN
Last Name:GIANNINI
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 N 13TH ST
Mailing Address - Street 2:#1005
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-1561
Mailing Address - Country:US
Mailing Address - Phone:402-438-8569
Mailing Address - Fax:
Practice Address - Street 1:40TH AND HOLDREGE STREETS
Practice Address - Street 2:BOX 830740
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68583-0740
Practice Address - Country:US
Practice Address - Phone:402-472-4160
Practice Address - Fax:402-472-2551
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE65841223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47078998500Medicaid
NEP00253376OtherRAILROAD MEDICARE
NE4505OtherBCBS
NE278837Medicare PIN
NEV06831Medicare UPIN