Provider Demographics
NPI:1447286828
Name:HINSON, LANNY C (DDS)
Entity type:Individual
Prefix:
First Name:LANNY
Middle Name:C
Last Name:HINSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 THIMBLE SHOALS BLVD
Mailing Address - Street 2:BLDG C-1
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-873-2577
Mailing Address - Fax:757-873-2796
Practice Address - Street 1:606 THIMBLE SHOALS BLVD
Practice Address - Street 2:BLDG C-1
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-873-2577
Practice Address - Fax:757-873-2796
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401003741122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist