Provider Demographics
NPI:1285340109
Name:REID, LINDSEY ERIN
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ERIN
Last Name:REID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460956 E 1023 RD
Mailing Address - Street 2:
Mailing Address - City:SALLISAW
Mailing Address - State:OK
Mailing Address - Zip Code:74955-8974
Mailing Address - Country:US
Mailing Address - Phone:918-207-2813
Mailing Address - Fax:
Practice Address - Street 1:460956 E 1023 RD
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-8974
Practice Address - Country:US
Practice Address - Phone:918-351-7135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3882124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist