Provider Demographics
NPI:1225050313
Name:LANIER, JOAN ELENA (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:ELENA
Last Name:LANIER
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 1:28411 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-5544
Mailing Address - Country:US
Mailing Address - Phone:248-948-1998
Mailing Address - Fax:248-948-0007
Practice Address - Street 1:28411 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 230
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-5548
Practice Address - Country:US
Practice Address - Phone:248-948-1998
Practice Address - Fax:248-948-0007
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI11082 AND 8121223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics