Provider Demographics
NPI:1932853538
Name:LANG, RUDOLPH DEAN JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUDOLPH
Middle Name:DEAN
Last Name:LANG
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 1:318 NORTHCREEK BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-1935
Mailing Address - Country:US
Mailing Address - Phone:615-239-4000
Mailing Address - Fax:
Practice Address - Street 1:318 NORTHCREEK BLVD STE 400
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-1935
Practice Address - Country:US
Practice Address - Phone:615-239-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-11
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12289122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist