Provider Demographics
NPI:1972162493
Name:BESSMER, LUKE RILEY (DDS)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:RILEY
Last Name:BESSMER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 S 101ST ST APT 215
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-6001
Mailing Address - Country:US
Mailing Address - Phone:402-321-1413
Mailing Address - Fax:
Practice Address - Street 1:8910 INDIAN HILLS DR STE 200
Practice Address - Street 2:
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:
Is Sole Proprietor?:No
Enumeration Date:2019-06-08
Last Update Date:2019-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7538122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist