Provider Demographics
NPI:1477514255
Name:SHUMWAY, LYNN ANDREW JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:ANDREW
Last Name:SHUMWAY
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 S GILBERT RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-5102
Mailing Address - Country:US
Mailing Address - Phone:480-820-3400
Mailing Address - Fax:480-820-5677
Practice Address - Street 1:3150 S GILBERT RD
Practice Address - Street 2:SUITE #1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-5102
Practice Address - Country:US
Practice Address - Phone:480-820-3400
Practice Address - Fax:480-820-5677
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ26791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice