Provider Demographics
NPI:1275710295
Name:LINDFORS, DENNIS PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:PATRICK
Last Name:LINDFORS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 E BAY DR NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-7601
Mailing Address - Country:US
Mailing Address - Phone:253-365-0050
Mailing Address - Fax:
Practice Address - Street 1:25875 SCIENCE PARK DR # AC116
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7304
Practice Address - Country:US
Practice Address - Phone:216-448-0218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR45862085R0202X
WAMD600308842085R0202X
LA0264452085R0202X
FLME1384282085R0202X
OH35.1351232085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05035595Medicaid
LA1063703Medicaid
AL1275710295Medicaid
WASEE NPIMedicaid
WASEE NPIMedicaid