Provider Demographics
NPI:1740292200
Name:BRIGHT, LENNA JAN (DMD)
Entity type:Individual
Prefix:DR
First Name:LENNA
Middle Name:JAN
Last Name:BRIGHT
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 1:1162 CIRBY WAY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4479
Mailing Address - Country:US
Mailing Address - Phone:916-781-3334
Mailing Address - Fax:916-781-3350
Practice Address - Street 1:5433 PALM AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-2317
Practice Address - Country:US
Practice Address - Phone:916-348-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37025122300000X
PA026569L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist