Provider Demographics
NPI:1558779850
Name:WEBER, LORI LORENA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:LORENA
Last Name:WEBER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LORI
Other - Middle Name:LORENA
Other - Last Name:BIASI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:16212 E INDIANA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216
Mailing Address - Country:US
Mailing Address - Phone:509-922-3333
Mailing Address - Fax:509-922-6533
Practice Address - Street 1:16212 E INDIANA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216
Practice Address - Country:US
Practice Address - Phone:509-922-3333
Practice Address - Fax:509-922-6533
Is Sole Proprietor?:No
Enumeration Date:2014-07-30
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60483122300000X
WADE60483485122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA372280OtherDEPARTMENT OF LABOR & INDUSTRIES