Provider Demographics
NPI:1396475984
Name:HODGES, LAUREN BRITTEN (DDS)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:BRITTEN
Last Name:HODGES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:ELIZABETH
Other - Last Name:BRITTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2000 4TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-4026
Mailing Address - Country:US
Mailing Address - Phone:806-655-4181
Mailing Address - Fax:
Practice Address - Street 1:2000 4TH AVE
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79015-4026
Practice Address - Country:US
Practice Address - Phone:806-655-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38627122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist