Provider Demographics
NPI:1902081185
Name:HERRMANN, LORRAINE ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:ANN
Last Name:HERRMANN
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 1:268 W MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-3347
Mailing Address - Country:US
Mailing Address - Phone:516-378-3200
Mailing Address - Fax:516-867-6767
Practice Address - Street 1:268 W MERRICK RD
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3347
Practice Address - Country:US
Practice Address - Phone:516-378-3200
Practice Address - Fax:516-867-6767
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0430151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice