Provider Demographics
NPI:1023069549
Name:LEHRIAN, JOHN F (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:LEHRIAN
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 1:100 STATE ST
Mailing Address - Street 2:SUITE B102
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1452
Mailing Address - Country:US
Mailing Address - Phone:814-454-3871
Mailing Address - Fax:814-454-6294
Practice Address - Street 1:100 STATE ST
Practice Address - Street 2:SUITE B102
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1452
Practice Address - Country:US
Practice Address - Phone:814-454-3871
Practice Address - Fax:814-454-6294
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017478L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0510850Medicaid
PA0510850Medicaid
PWT28649Medicare UPIN