Provider Demographics
NPI:1255175816
Name:DEAN, LINDSEY (DMD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:DEAN
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 1:2355 FACULTY DR # B
Mailing Address - Street 2:
Mailing Address - City:USAF ACADEMY
Mailing Address - State:CO
Mailing Address - Zip Code:80840-1805
Mailing Address - Country:US
Mailing Address - Phone:719-333-5025
Mailing Address - Fax:
Practice Address - Street 1:2355 FACULTY DR # B
Practice Address - Street 2:
Practice Address - City:USAF ACADEMY
Practice Address - State:CO
Practice Address - Zip Code:80840-1805
Practice Address - Country:US
Practice Address - Phone:719-333-5025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY11186122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist