Provider Demographics
NPI:1134225113
Name:LANNI, DENNIS JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:JAMES
Last Name:LANNI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-2105
Mailing Address - Country:US
Mailing Address - Phone:401-354-4460
Mailing Address - Fax:401-354-4480
Practice Address - Street 1:667 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-2105
Practice Address - Country:US
Practice Address - Phone:401-354-4460
Practice Address - Fax:401-354-4480
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00460111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIU88887Medicare UPIN