Provider Demographics
NPI:1669935490
Name:MILLS, LINDSEY RYAN (DMD)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:RYAN
Last Name:MILLS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:RYAN
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:502 MONTGOMERY HWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216
Mailing Address - Country:US
Mailing Address - Phone:205-822-2808
Mailing Address - Fax:
Practice Address - Street 1:502 MONTGOMERY HWY
Practice Address - Street 2:SUITE 201
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216
Practice Address - Country:US
Practice Address - Phone:205-822-2808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0006627122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty