Provider Demographics
NPI:1598220618
Name:RINARD, LAUREN (DMD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:RINARD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 SW 78TH AVE APT 803
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3457
Mailing Address - Country:US
Mailing Address - Phone:928-308-9147
Mailing Address - Fax:
Practice Address - Street 1:112 IRONWORKS AVE STE B1
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544-2058
Practice Address - Country:US
Practice Address - Phone:574-255-4964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-02
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0116221223P0221X
IN12013049A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0221XDental ProvidersDentistPediatric Dentistry