Provider Demographics
NPI:1881116788
Name:PAULEY, SEAN D (DDS)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:D
Last Name:PAULEY
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 1:8926 BROKEN SPOKE DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68507-3403
Mailing Address - Country:US
Mailing Address - Phone:402-540-6124
Mailing Address - Fax:
Practice Address - Street 1:5930 S 58TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6402
Practice Address - Country:US
Practice Address - Phone:402-423-9045
Practice Address - Fax:402-423-9048
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2023-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE73901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice