Healthcare Provider Details

I. General information

NPI: 1295943595
Provider Name (Legal Business Name): THOMAS JOACHIM LANEY D.D.S. , M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 S PIONEER WAY
MOSES LAKE WA
98837-2410
US

IV. Provider business mailing address

1308 S PIONEER WAY
MOSES LAKE WA
98837-2410
US

V. Phone/Fax

Practice location:
  • Phone: 509-765-5141
  • Fax: 509-765-5891
Mailing address:
  • Phone: 509-765-5141
  • Fax: 509-765-5891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDE00005663
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberMD00024468
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: