Provider Demographics
NPI:1922214717
Name:LAKING, LORRAINE LYNN (RDH)
Entity Type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:LYNN
Last Name:LAKING
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 SCHUMWAY ROAD
Mailing Address - Street 2:
Mailing Address - City:NEVERSINK
Mailing Address - State:NY
Mailing Address - Zip Code:12765
Mailing Address - Country:US
Mailing Address - Phone:845-985-0290
Mailing Address - Fax:
Practice Address - Street 1:230 ROCKHILL DRIVE
Practice Address - Street 2:
Practice Address - City:ROCKHILL
Practice Address - State:NY
Practice Address - Zip Code:12755
Practice Address - Country:US
Practice Address - Phone:845-796-3160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0204871124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist