Provider Demographics
NPI:1104208974
Name:LANINGHAM, STUART (DDS)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:LANINGHAM
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 1:1978 MOUNT MORIAH RD
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24263-6873
Mailing Address - Country:US
Mailing Address - Phone:757-817-4329
Mailing Address - Fax:
Practice Address - Street 1:111 W FAIRVIEW AVE STE 3
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-5632
Practice Address - Country:US
Practice Address - Phone:423-410-3222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014148571223G0001X
TN112451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice