Provider Demographics
NPI:1518393990
Name:LANE, ALINA LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALINA
Middle Name:LEE
Last Name:LANE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 WASHINGTON SQ N
Mailing Address - Street 2:STREET LEVEL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-9168
Mailing Address - Country:US
Mailing Address - Phone:929-243-1293
Mailing Address - Fax:212-777-0530
Practice Address - Street 1:24 WASHINGTON SQ N
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-9168
Practice Address - Country:US
Practice Address - Phone:929-243-1293
Practice Address - Fax:212-777-0530
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056908-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist