Provider Demographics
NPI:1952026023
Name:LINDLEY, JESSICA (RDH)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:LINDLEY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 PINE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:TN
Mailing Address - Zip Code:38060-4177
Mailing Address - Country:US
Mailing Address - Phone:901-921-0989
Mailing Address - Fax:
Practice Address - Street 1:2059 S HOUSTON LEVEE RD STE 126
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38139-6970
Practice Address - Country:US
Practice Address - Phone:901-425-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7155124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist