Provider Demographics
NPI:1790817815
Name:LANIAUSKAS, MARIUS M (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIUS
Middle Name:M
Last Name:LANIAUSKAS
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 1:5825 LANDERBROOK DR
Mailing Address - Street 2:SUITE 222
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-6532
Mailing Address - Country:US
Mailing Address - Phone:216-752-8888
Mailing Address - Fax:440-684-1624
Practice Address - Street 1:5825 LANDERBROOK DR
Practice Address - Street 2:SUITE 222
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-6532
Practice Address - Country:US
Practice Address - Phone:216-752-8888
Practice Address - Fax:440-684-1624
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH164451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice