Provider Demographics
NPI:1073742896
Name:COLLINS, LINDSEY B (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:B
Last Name:COLLINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LINDSEY
Other - Middle Name:M
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2001 NW EVANGELINE TRWY
Mailing Address - Street 2:#3
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-1927
Mailing Address - Country:US
Mailing Address - Phone:337-205-2644
Mailing Address - Fax:
Practice Address - Street 1:2001 NW EVANGELINE TRWY
Practice Address - Street 2:#3
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-1927
Practice Address - Country:US
Practice Address - Phone:985-373-5783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9005122300000X
MO2013008863122300000X
LA59591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist