Provider Demographics
NPI:1831103043
Name:LEHRHAUPT, NINA B (DMD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:B
Last Name:LEHRHAUPT
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 1:3436 PROGRESS STREET
Mailing Address - Street 2:SUITE A-3
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1103
Mailing Address - Country:US
Mailing Address - Phone:908-756-4867
Mailing Address - Fax:
Practice Address - Street 1:34 PROGRESS ST # 36
Practice Address - Street 2:SUITE A-3
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1103
Practice Address - Country:US
Practice Address - Phone:908-756-4867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI182771223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics