Healthcare Provider Details
I. General information
NPI: 1861013492
Provider Name (Legal Business Name): IRADA LAHNEMANN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/05/2020
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
223 N LIME ST
LANCASTER PA
17602-2748
US
IV. Provider business mailing address
7505 GRAND LELY DR
NAPLES FL
34113-1753
US
V. Phone/Fax
- Phone: 717-394-3793
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | DRPM2209 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | DS043348 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: