Provider Demographics
NPI:1346217742
Name:EZEKOWITZ, LINDI J (DDS)
Entity Type:Individual
Prefix:
First Name:LINDI
Middle Name:J
Last Name:EZEKOWITZ
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 1:7 GRAF RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-4078
Mailing Address - Country:US
Mailing Address - Phone:978-462-2227
Mailing Address - Fax:978-462-4343
Practice Address - Street 1:7 GRAF RD STE 2A
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-4078
Practice Address - Country:US
Practice Address - Phone:978-462-2227
Practice Address - Fax:978-462-4343
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210581223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX09133OtherBCBS - DENTAL