Provider Demographics
NPI:1831487362
Name:LEHNES, KEVIN GARY (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:GARY
Last Name:LEHNES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 FOREST ST
Mailing Address - Street 2:PH-22
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-1848
Mailing Address - Country:US
Mailing Address - Phone:973-214-9211
Mailing Address - Fax:
Practice Address - Street 1:50 FOREST ST
Practice Address - Street 2:PH-22
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-1848
Practice Address - Country:US
Practice Address - Phone:973-214-9211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0105381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics