Provider Demographics
NPI:1952998627
Name:KIRKPATRICK, ADDISON GRACE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADDISON
Middle Name:GRACE
Last Name:KIRKPATRICK
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 1:989375 NEBRASKA MEDICAL CENTER- ADULT GENERAL DENTISTRY
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-0001
Mailing Address - Country:US
Mailing Address - Phone:402-559-6327
Mailing Address - Fax:
Practice Address - Street 1:989375 NEBRASKA MEDICAL CENTER- ADULT GENERAL DENTISTRY
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-0001
Practice Address - Country:US
Practice Address - Phone:402-559-6327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE172122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist