Provider Demographics
NPI:1417202797
Name:MILLEA, MEGAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:MILLEA
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 1:4843 S 24TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-2704
Mailing Address - Country:US
Mailing Address - Phone:402-731-0388
Mailing Address - Fax:
Practice Address - Street 1:4843 S 24TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-2704
Practice Address - Country:US
Practice Address - Phone:402-731-0388
Practice Address - Fax:402-731-0388
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7043122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist