Provider Demographics
NPI:1124030952
Name:HEPPNER, LAWRENCE JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JOSEPH
Last Name:HEPPNER
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 1:7200 PADDISON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2370
Mailing Address - Country:US
Mailing Address - Phone:513-232-2654
Mailing Address - Fax:513-232-3314
Practice Address - Street 1:7200 PADDISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2370
Practice Address - Country:US
Practice Address - Phone:513-232-2654
Practice Address - Fax:513-232-3314
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0140191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice