Provider Demographics
NPI:1780033621
Name:RODRIGUEZ, LINDSEY BLAIR (DMD)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:BLAIR
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:LINDSEY
Other - Middle Name:BLAIR
Other - Last Name:RISDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:22051 US HIGHWAY 72 STE F
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-2665
Mailing Address - Country:US
Mailing Address - Phone:256-434-5667
Mailing Address - Fax:
Practice Address - Street 1:22051 US HIGHWAY 72 STE F
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-2665
Practice Address - Country:US
Practice Address - Phone:256-434-5667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL63001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry