Provider Demographics
NPI:1912472192
Name:LONNIE R. FLAGTWET, DDS
Entity Type:Organization
Organization Name:LONNIE R. FLAGTWET, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:FLAGTWET
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-483-6662
Mailing Address - Street 1:7121 STEPHANIE LN STE 112
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5324
Mailing Address - Country:US
Mailing Address - Phone:402-483-6662
Mailing Address - Fax:
Practice Address - Street 1:7121 STEPHANIE LN STE 112
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5324
Practice Address - Country:US
Practice Address - Phone:402-483-6662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1598784472OtherINDIVIDUAL NPI