Provider Demographics
NPI:1255476701
Name:SHENDELL, LAWRENCE ROBERT
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ROBERT
Last Name:SHENDELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:LAWRENCE
Other - Middle Name:
Other - Last Name:SHENDELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:65 E NORTHFIELD RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039
Mailing Address - Country:US
Mailing Address - Phone:973-992-5834
Mailing Address - Fax:973-992-5727
Practice Address - Street 1:65 E NORTHFIELD RD
Practice Address - Street 2:SUITE C
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039
Practice Address - Country:US
Practice Address - Phone:973-992-5834
Practice Address - Fax:973-992-5727
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01007700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist