Provider Demographics
NPI:1841555471
Name:LANIGAN, PETER ANDREW JR (DDS)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:ANDREW
Last Name:LANIGAN
Suffix:JR
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 1:61 IRVINGTON RD
Mailing Address - Street 2:
Mailing Address - City:KILMARNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22482-3826
Mailing Address - Country:US
Mailing Address - Phone:804-435-1220
Mailing Address - Fax:
Practice Address - Street 1:61 IRVINGTON RD
Practice Address - Street 2:
Practice Address - City:KILMARNOCK
Practice Address - State:VA
Practice Address - Zip Code:22482-3826
Practice Address - Country:US
Practice Address - Phone:804-435-1220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014136721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice