MEDICARE: DR. THOMAS EDWARD LENHART II DMD

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	1223D0004X	Dental Anesthesiology	38867	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1223D0004X	OTHER	CA	NON-PROVIDER

General Provider Information

NPI Number	:	1316124639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS EDWARD LENHART II DMD

Provider Business Mailing Address
First Line	:	5433 CLAYTON RD
Second Line	:	SUITE K#304
City	:	CLAYTON
State	:	CA
Zip	:	94517-1089
Country	:	US
Telephone Number	:	925-787-1772
Fax Number	:	888-908-5286

Provider Business Practice Location Address
First Line	:	5433 CLAYTON RD
Second Line	:	SUITE K#304
City	:	CLAYTON
State	:	CA
Zip	:	94517-1089
Country	:	US
Telephone Number	:	925-787-1772
Fax Number	:	888-908-5286

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2008
Last Update Date	:	03/17/2014

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