Provider Demographics
NPI:1326663139
Name:LICHTEN, SHAYNA BETH (DMD)
Entity type:Individual
Prefix:DR
First Name:SHAYNA
Middle Name:BETH
Last Name:LICHTEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:SHAYNA
Other - Middle Name:BETH
Other - Last Name:CRANDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8217 E WICKER CT
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-4049
Mailing Address - Country:US
Mailing Address - Phone:612-735-3333
Mailing Address - Fax:
Practice Address - Street 1:913 CECELIA ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51105-3336
Practice Address - Country:US
Practice Address - Phone:346-299-9684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD010684122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist