Healthcare Provider Details

I. General information

NPI: 1992443238
Provider Name (Legal Business Name): LANEY ELIZABETH VAUGHAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12725 PATRICK HENRY DR
NEWPORT NEWS VA
23602
US

IV. Provider business mailing address

12725 PATRICK HENRY DR
NEWPORT NEWS VA
23602
US

V. Phone/Fax

Practice location:
  • Phone: 757-874-6712
  • Fax: 757-886-1319
Mailing address:
  • Phone: 757-874-6712
  • Fax: 757-886-1319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401418072
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: