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General NPI Number Information
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NPI Number | 1073477824
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Entity Type | Organization
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Legal Business Name | JERRY L LANIER DDS INC
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 200 W SHAW AVE STE 101
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City | CLOVIS
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State | CA
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Zip | 93612-3698
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Country | US
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Telephone | 559-691-4591
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Fax | 559-691-4592
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Provider Business Mailing Address
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Address Line | 5449 HOLLYWOOD BLVD STE A
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City | LOS ANGELES
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State | CA
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Zip | 90027-3454
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | HR DIRECTOR
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Name | MICHELLE LOBO
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Credential |
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Telephone | 661-312-1433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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