Provider Demographics
NPI:1912968637
Name:TERENS, LANA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:LANA
Middle Name:
Last Name:TERENS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 MOTT AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCK AWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4101
Mailing Address - Country:US
Mailing Address - Phone:718-327-8816
Mailing Address - Fax:718-327-5197
Practice Address - Street 1:1908 MOTT AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCK AWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4101
Practice Address - Country:US
Practice Address - Phone:718-327-8816
Practice Address - Fax:718-327-5197
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049077122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02110098Medicaid
NY9176812OtherDORAL