Provider Demographics
NPI:1588673081
Name:KATHREIN, JOANN RUTH (DDS)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:RUTH
Last Name:KATHREIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8910 INDIAN HILLS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4127
Mailing Address - Country:US
Mailing Address - Phone:402-397-3400
Mailing Address - Fax:402-397-4225
Practice Address - Street 1:8910 INDIAN HILLS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4127
Practice Address - Country:US
Practice Address - Phone:402-397-3400
Practice Address - Fax:402-397-4225
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE60281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice