Provider Demographics
NPI:1801990262
Name:TEMPERO, RICHARD M (MD DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:M
Last Name:TEMPERO
Suffix:
Gender:M
Credentials:MD DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1349 S 101ST ST
Mailing Address - Street 2:#304
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124
Mailing Address - Country:US
Mailing Address - Phone:402-397-7837
Mailing Address - Fax:
Practice Address - Street 1:13215 BIRCH DR
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164
Practice Address - Country:US
Practice Address - Phone:402-397-1205
Practice Address - Fax:402-390-1074
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE128931223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025196900Medicaid
NE087501Medicare ID - Type Unspecified
T83768Medicare UPIN