Provider Demographics
NPI:1891810057
Name:ANTOSEK, LINDSEY H (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:H
Last Name:ANTOSEK
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 1:1 WEAVER DR
Mailing Address - Street 2:PROFESSIONAL BUILDING, SUITE #1
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-4773
Mailing Address - Country:US
Mailing Address - Phone:336-248-5057
Mailing Address - Fax:336-248-5355
Practice Address - Street 1:1 WEAVER DR
Practice Address - Street 2:PROFESSIONAL BUILDING, SUITE #1
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-4773
Practice Address - Country:US
Practice Address - Phone:336-248-5057
Practice Address - Fax:336-248-5355
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC79481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902024Medicaid