Provider Demographics
NPI:1609865518
Name:REED, JENNIFER ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANN
Last Name:REED
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 1:2900 S 70TH ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-3688
Mailing Address - Country:US
Mailing Address - Phone:402-488-5007
Mailing Address - Fax:402-488-5033
Practice Address - Street 1:2900 S 70TH ST
Practice Address - Street 2:SUITE 230
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-3688
Practice Address - Country:US
Practice Address - Phone:402-488-5007
Practice Address - Fax:402-488-5033
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-14
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE57821223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE91-179300500Medicaid