Provider Demographics
NPI:1144291469
Name:HINZE, STEVEN ROBERT (DDS OMS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ROBERT
Last Name:HINZE
Suffix:
Gender:M
Credentials:DDS OMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 S WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6079
Mailing Address - Country:US
Mailing Address - Phone:308-532-5283
Mailing Address - Fax:308-532-4770
Practice Address - Street 1:921 S WILLOW ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6079
Practice Address - Country:US
Practice Address - Phone:308-532-5283
Practice Address - Fax:308-532-4770
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE42521223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470632516-00Medicaid
NET77035Medicare UPIN
NE095109Medicare ID - Type Unspecified