Provider Demographics
NPI:1457511800
Name:EIDSON, LINDSEY DAWN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:DAWN
Last Name:EIDSON
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W TREMONT AVE
Mailing Address - Street 2:UNIT 506
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-4941
Mailing Address - Country:US
Mailing Address - Phone:919-612-5986
Mailing Address - Fax:
Practice Address - Street 1:2711 RANDOLPH RD
Practice Address - Street 2:SUITE 600
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2034
Practice Address - Country:US
Practice Address - Phone:704-334-7202
Practice Address - Fax:704-372-2690
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8486122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist