Provider Demographics
NPI:1679701387
Name:ANZALONE, LINDSEY DEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:DEY
Last Name:ANZALONE
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 1:2114 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-3847
Mailing Address - Country:US
Mailing Address - Phone:712-252-3440
Mailing Address - Fax:
Practice Address - Street 1:2114 PIERCE ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3847
Practice Address - Country:US
Practice Address - Phone:712-252-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD3134122300000X
NE7029122300000X
IA08968122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist