Provider Demographics
NPI:1548228513
Name:FALENDER, LAWRENCE G (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:G
Last Name:FALENDER
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 1:1320 NORTH POST ROAD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4210
Mailing Address - Country:US
Mailing Address - Phone:317-898-2555
Mailing Address - Fax:317-898-2556
Practice Address - Street 1:1320 NORTH POST ROAD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4210
Practice Address - Country:US
Practice Address - Phone:317-898-2555
Practice Address - Fax:317-898-2556
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12008529A1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100129860AMedicaid
IN100129860AMedicaid
INT34511Medicare UPIN