Provider Demographics
NPI:1043215056
Name:LANHAM, LAWRENCE BINKLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:BINKLEY
Last Name:LANHAM
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 1:10633 PARK PRESTON DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-4046
Mailing Address - Country:US
Mailing Address - Phone:972-863-8981
Mailing Address - Fax:
Practice Address - Street 1:1476 W BUCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-4201
Practice Address - Country:US
Practice Address - Phone:214-919-4388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2017-11-01
Deactivation Date:2006-03-31
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
TX104221223P0221X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111155104Medicaid