Provider Demographics
NPI:1932859386
Name:LINDSAY D CHRISTENSEN DMD LLC
Entity Type:Organization
Organization Name:LINDSAY D CHRISTENSEN DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING LEAD
Authorized Official - Prefix:
Authorized Official - First Name:VINCETA
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-869-3789
Mailing Address - Street 1:1 CALLE MEDICO STE 2
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4764
Mailing Address - Country:US
Mailing Address - Phone:505-983-4117
Mailing Address - Fax:505-983-0694
Practice Address - Street 1:1 CALLE MEDICO STE 2
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4764
Practice Address - Country:US
Practice Address - Phone:505-983-4117
Practice Address - Fax:505-983-0694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty