Provider Demographics
NPI:1922366384
Name:O'FARRIELL, LINDSEY MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:MARIE
Last Name:O'FARRIELL
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:PO BOX 1989
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95015-1989
Mailing Address - Country:US
Mailing Address - Phone:408-688-1555
Mailing Address - Fax:408-366-1214
Practice Address - Street 1:19020 COX AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-4156
Practice Address - Country:US
Practice Address - Phone:408-688-1555
Practice Address - Fax:408-366-1214
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA594101223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist