Provider Demographics
NPI:1952641243
Name:COLLINS, LINDSEY MICHELLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:MICHELLE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3362 S MCCARRAN BLVD
Mailing Address - Street 2:#3362
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6442
Mailing Address - Country:US
Mailing Address - Phone:775-329-5437
Mailing Address - Fax:775-829-1553
Practice Address - Street 1:3362 S MCCARRAN BLVD
Practice Address - Street 2:#3362
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6442
Practice Address - Country:US
Practice Address - Phone:775-329-5437
Practice Address - Fax:775-829-1553
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA620451223G0001X
NV63621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1952641243Medicaid