Provider Demographics
NPI:1154508877
Name:LENK, MISTY DAWN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MISTY
Middle Name:DAWN
Last Name:LENK
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 COMMONS PKWY
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24083
Mailing Address - Country:US
Mailing Address - Phone:540-966-3990
Mailing Address - Fax:540-966-3997
Practice Address - Street 1:7523 NEW BARRENS CT
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-3189
Practice Address - Country:US
Practice Address - Phone:540-892-1021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014116171223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics