Provider Demographics
NPI:1932271491
Name:PLATE, FARRAH LYNN (DDS)
Entity Type:Individual
Prefix:
First Name:FARRAH
Middle Name:LYNN
Last Name:PLATE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9635 KOI ROCK DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9678
Mailing Address - Country:US
Mailing Address - Phone:402-499-0624
Mailing Address - Fax:402-313-4380
Practice Address - Street 1:9635 KOI ROCK DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9678
Practice Address - Country:US
Practice Address - Phone:402-499-0624
Practice Address - Fax:402-313-4380
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6546122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025400000Medicaid
NE10025400000Medicaid