Provider Demographics
NPI:1851516413
Name:LYDEN, JAMES ALLAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALLAN
Last Name:LYDEN
Suffix:
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 1:2210 E HENRIETTA RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-4520
Mailing Address - Country:US
Mailing Address - Phone:585-424-3310
Mailing Address - Fax:585-334-6451
Practice Address - Street 1:2210 E HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4520
Practice Address - Country:US
Practice Address - Phone:585-424-3310
Practice Address - Fax:585-334-6451
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043179122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY043179OtherSTATE LICENSE