MEDICARE: LASANTA & HERNANDEZ PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1144782509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LASANTA & HERNANDEZ PLLC

Provider Business Mailing Address
First Line	:	PO BOX 952066
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0051
Country	:	US
Telephone Number	:	919-213-0505
Fax Number	:	919-213-0505

Provider Business Practice Location Address
First Line	:	3622 SHANNON RD STE 101
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-3771
Country	:	US
Telephone Number	:	919-493-1402
Fax Number	:	919-403-2392

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. REINALDO LASANTA-GARCIA
Credential	:	DMD
Telephone Number	:	919-213-0505

Provider Enumeration Date	:	04/04/2019
Last Update Date	:	03/23/2026

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