Provider Demographics
NPI:1770840589
Name:JAMES B LEWER DDS ND
Entity Type:Organization
Organization Name:JAMES B LEWER DDS ND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:LEWER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, ND
Authorized Official - Phone:402-391-1919
Mailing Address - Street 1:2420 S 73RD ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2396
Mailing Address - Country:US
Mailing Address - Phone:402-391-1919
Mailing Address - Fax:404-391-1869
Practice Address - Street 1:2420 S 73RD ST
Practice Address - Street 2:SUITE 300
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2396
Practice Address - Country:US
Practice Address - Phone:402-391-1919
Practice Address - Fax:404-391-1869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid