Provider Demographics
NPI:1104106566
Name:TYMON, LINDSAY ELIZABETH (DMD)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:ELIZABETH
Last Name:TYMON
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 1:4428 16TH ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-2130
Mailing Address - Country:US
Mailing Address - Phone:717-799-4312
Mailing Address - Fax:
Practice Address - Street 1:6707 OLD DOMINION DR
Practice Address - Street 2:STE 240
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4504
Practice Address - Country:US
Practice Address - Phone:703-734-2750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413245122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist