Provider Demographics
NPI:1720658537
Name:VENERI, LAYNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAYNE
Middle Name:
Last Name:VENERI
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 1:2491 SEAGULL DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-7878
Mailing Address - Country:US
Mailing Address - Phone:304-921-2851
Mailing Address - Fax:
Practice Address - Street 1:275 N NC 16 BUSINESS HWY STE 101
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-3008
Practice Address - Country:US
Practice Address - Phone:980-222-7501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12339122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12339OtherNORTH CAROLINA BOARD OF DENTAL EXAMINERS