Provider Demographics
NPI:1013047810
Name:STROHMYER, RANDAL E (DDS)
Entity Type:Individual
Prefix:DR
First Name:RANDAL
Middle Name:E
Last Name:STROHMYER
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 1:513 10TH ST
Mailing Address - Street 2:
Mailing Address - City:GOTHENBURG
Mailing Address - State:NE
Mailing Address - Zip Code:69138
Mailing Address - Country:US
Mailing Address - Phone:308-537-7195
Mailing Address - Fax:308-537-7196
Practice Address - Street 1:513 10TH STREET
Practice Address - Street 2:
Practice Address - City:GOTHENBURG
Practice Address - State:NE
Practice Address - Zip Code:69138
Practice Address - Country:US
Practice Address - Phone:308-537-7195
Practice Address - Fax:308-537-7196
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4883122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47064413800Medicaid