Healthcare Provider Details

I. General information

NPI: 1881649366
Provider Name (Legal Business Name): DENNIS EUGENE LENHART JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 CHASE AVE
WALLA WALLA WA
99362-2924
US

IV. Provider business mailing address

PO BOX 1398
WALLA WALLA WA
99362-0309
US

V. Phone/Fax

Practice location:
  • Phone: 509-897-3790
  • Fax: 509-897-5558
Mailing address:
  • Phone: 509-527-8153
  • Fax: 509-527-8010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD60219945
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number5785
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number5785
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: