Provider Demographics
NPI:1265922611
Name:LAPP, DIANA JO (LDH)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:JO
Last Name:LAPP
Suffix:
Gender:F
Credentials:LDH
Other - Prefix:MRS
Other - First Name:DIANA
Other - Middle Name:JO
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LDH
Mailing Address - Street 1:18753 CROMARTY CIR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-7548
Mailing Address - Country:US
Mailing Address - Phone:317-414-6747
Mailing Address - Fax:
Practice Address - Street 1:6426 WHITESTOWN PKWY
Practice Address - Street 2:
Practice Address - City:WHITESTOWN
Practice Address - State:IN
Practice Address - Zip Code:46075-7604
Practice Address - Country:US
Practice Address - Phone:317-732-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN13004787A124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist