Provider Demographics
NPI:1740764869
Name:SUMNER, LANEY JANE (RDH)
Entity type:Individual
Prefix:
First Name:LANEY
Middle Name:JANE
Last Name:SUMNER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5654 CATHY LN
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-5206
Mailing Address - Country:US
Mailing Address - Phone:530-519-7719
Mailing Address - Fax:
Practice Address - Street 1:1350 CHURN CREEK RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-4168
Practice Address - Country:US
Practice Address - Phone:530-519-7719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31181124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist