Provider Demographics
NPI:1184662413
Name:LANNING, GEORGE E (DDS)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:E
Last Name:LANNING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1569 BLUE PHLOX DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-7131
Mailing Address - Country:US
Mailing Address - Phone:317-272-5818
Mailing Address - Fax:317-554-0245
Practice Address - Street 1:VETERANS AFFAIRS HOSPITAL
Practice Address - Street 2:1481 W 10TH ST.
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-554-0000
Practice Address - Fax:317-554-0245
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007259A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice