Provider Demographics
NPI:1164636981
Name:HINRICHS, ROBERT MARK (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARK
Last Name:HINRICHS
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 1:1919 S 40TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5243
Mailing Address - Country:US
Mailing Address - Phone:402-488-0959
Mailing Address - Fax:402-488-2169
Practice Address - Street 1:1919 S 40TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5243
Practice Address - Country:US
Practice Address - Phone:402-488-0959
Practice Address - Fax:402-488-2169
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5870122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist