Provider Demographics
NPI:1053859892
Name:LANCASTER, LYDIA ANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:ANNE
Last Name:LANCASTER
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 1:1370 GRANDVIEW AVE
Mailing Address - Street 2:APT 408
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1370 GRANDVIEW AVE
Practice Address - Street 2:APT 408
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2805
Practice Address - Country:US
Practice Address - Phone:573-820-2421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.3689122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist