Provider Demographics
NPI:1245447846
Name:SKAKUN, LANA (DMD)
Entity type:Individual
Prefix:DR
First Name:LANA
Middle Name:
Last Name:SKAKUN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 FARMINGTON AVE #129
Mailing Address - Street 2:
Mailing Address - City:WEST HAARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119
Mailing Address - Country:US
Mailing Address - Phone:860-489-9091
Mailing Address - Fax:
Practice Address - Street 1:836 FARMINGTON AVE #129 LANA SKAKUN
Practice Address - Street 2:
Practice Address - City:WEST HAARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119
Practice Address - Country:US
Practice Address - Phone:860-489-9091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0095821223G0001X
CT95821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice