Healthcare Provider Details

I. General information

NPI: 1528152733
Provider Name (Legal Business Name): LANNETTE R HUFFMAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LANNETTE R HUFFMAN DDS

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1878 HIGH ST
LAKEPORT CA
95453-3615
US

IV. Provider business mailing address

1878 HIGH ST
LAKEPORT CA
95453-3615
US

V. Phone/Fax

Practice location:
  • Phone: 707-263-7768
  • Fax: 707-263-1120
Mailing address:
  • Phone: 707-263-7768
  • Fax: 707-263-1120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number43796
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number43796
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: