Provider Demographics
NPI:1558796912
Name:3I DENTAL, LLC
Entity Type:Organization
Organization Name:3I DENTAL, LLC
Other - Org Name:40TH AND DODGE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:F
Authorized Official - Last Name:MATRANGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDD,MS
Authorized Official - Phone:402-884-4400
Mailing Address - Street 1:111 N 40TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2356
Mailing Address - Country:US
Mailing Address - Phone:402-884-4400
Mailing Address - Fax:402-614-4812
Practice Address - Street 1:111 N 40TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2356
Practice Address - Country:US
Practice Address - Phone:402-884-4400
Practice Address - Fax:402-614-4812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty