Provider Demographics
NPI:1225320641
Name:ROZENDAAL, LINDSAY LOU (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:LOU
Last Name:ROZENDAAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LINDSAY
Other - Middle Name:LOU
Other - Last Name:LICHTENBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:7017 OLD SAUK RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1010
Mailing Address - Country:US
Mailing Address - Phone:608-833-1889
Mailing Address - Fax:608-662-7414
Practice Address - Street 1:7017 OLD SAUK RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1010
Practice Address - Country:US
Practice Address - Phone:608-833-1889
Practice Address - Fax:608-662-7414
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0290411223G0001X
WI6929-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice