Provider Demographics
NPI:1700922887
Name:LENICK, DIANNA LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:DIANNA
Middle Name:LYNN
Last Name:LENICK
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 1:21 NEW ORLEANS RD STE A
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-4797
Mailing Address - Country:US
Mailing Address - Phone:843-785-6285
Mailing Address - Fax:304-344-9302
Practice Address - Street 1:21 NEW ORLEANS RD
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-4732
Practice Address - Country:US
Practice Address - Phone:843-785-6285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2745122300000X
SC41601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentist