Provider Demographics
NPI:1588014013
Name:LENZ, ERICA KAYLA (DDS)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:KAYLA
Last Name:LENZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:KAYLA
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:101 NW 12TH AVE
Mailing Address - Street 2:STE.130
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604
Mailing Address - Country:US
Mailing Address - Phone:360-667-5676
Mailing Address - Fax:
Practice Address - Street 1:101 NW 12TH AVE
Practice Address - Street 2:STE.130
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604
Practice Address - Country:US
Practice Address - Phone:360-667-5676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-15
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7293122300000X
WADE60730978122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist