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General NPI Number Information
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NPI Number | 1033235494
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Entity Type | Individual
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Provider Name | LAN D DUCKETT DDS
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Gender | Male
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 01/04/2025
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Provider Practice Location Address
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Address Line | 600 W STRETT NW
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City | WASHINGTON
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State | DC
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Zip | 20059-4229
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Country | US
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Telephone | 202-806-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 2919 HIDEAWAY RD
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City | FAIRFAX
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State | VA
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Zip | 22031-1310
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Country | US
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Telephone | 571-215-1529
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DRN5780
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License Number State | DC
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