Provider Demographics
NPI:1447097308
Name:LINDSAY FREDERICK DMD LLC
Entity type:Organization
Organization Name:LINDSAY FREDERICK DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:FREDERICK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:330-892-0173
Mailing Address - Street 1:102 SPYGLASS CT SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-5602
Mailing Address - Country:US
Mailing Address - Phone:330-507-2017
Mailing Address - Fax:
Practice Address - Street 1:225 E STATE ROUTE 14 STE 205
Practice Address - Street 2:
Practice Address - City:COLUMBIANA
Practice Address - State:OH
Practice Address - Zip Code:44408-8490
Practice Address - Country:US
Practice Address - Phone:330-892-0173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice