Provider Demographics
NPI:1245703693
Name:LANDRY, LINDSEY RICHARD (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:RICHARD
Last Name:LANDRY
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 BEAULLIEU DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7226
Mailing Address - Country:US
Mailing Address - Phone:337-347-7365
Mailing Address - Fax:
Practice Address - Street 1:210 BEAULLIEU DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7226
Practice Address - Country:US
Practice Address - Phone:337-347-7365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA67051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics