Provider Demographics
NPI:1336675347
Name:RUNYAN, LINDSAY (DDS)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:RUNYAN
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 1:6518 WINFORD AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-0547
Mailing Address - Country:US
Mailing Address - Phone:513-712-9642
Mailing Address - Fax:
Practice Address - Street 1:6518 WINFORD AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45011-0547
Practice Address - Country:US
Practice Address - Phone:513-482-1828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.025057122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist