Provider Demographics
NPI:1306287545
Name:BACHRACH, LINDSAY JILL (DMD)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:JILL
Last Name:BACHRACH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:JILL
Other - Last Name:DENONNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:317 PAUL CT
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-3215
Mailing Address - Country:US
Mailing Address - Phone:347-992-5907
Mailing Address - Fax:
Practice Address - Street 1:88 W RIDGEWOOD AVE STE 1
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3141
Practice Address - Country:US
Practice Address - Phone:201-652-8875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0566861223G0001X
NJ22DI02828600122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice