Provider Demographics
NPI:1134417058
Name:LYONS, ROB DEAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ROB
Middle Name:DEAN
Last Name:LYONS
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 1:5955 MOUNT RUSHMORE RD STE A
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-8960
Mailing Address - Country:US
Mailing Address - Phone:605-791-5005
Mailing Address - Fax:605-791-3003
Practice Address - Street 1:5955 MOUNT RUSHMORE RD STE A
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701
Practice Address - Country:US
Practice Address - Phone:605-791-5005
Practice Address - Fax:605-791-3003
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD09741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice