Provider Demographics
NPI:1306804166
Name:LIND, JOYCE D (RDH)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:D
Last Name:LIND
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:D
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:634 HUDSON TER
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-3041
Mailing Address - Country:US
Mailing Address - Phone:212-677-7400
Mailing Address - Fax:212-529-2071
Practice Address - Street 1:122 EAST 23RD STREET
Practice Address - Street 2:UCP DENTAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:212-677-7400
Practice Address - Fax:212-529-2071
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019450124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist