Provider Demographics
NPI:1194070870
Name:LYONS, ALINA EVA (DMD)
Entity type:Individual
Prefix:DR
First Name:ALINA
Middle Name:EVA
Last Name:LYONS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:806 FARNSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-2104
Mailing Address - Country:US
Mailing Address - Phone:609-298-8309
Mailing Address - Fax:609-298-7002
Practice Address - Street 1:806 FARNSWORTH AVE
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-2104
Practice Address - Country:US
Practice Address - Phone:609-298-8309
Practice Address - Fax:609-298-7002
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI17331332B00000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies