Provider Demographics
NPI:1427090810
Name:LINDSLY, JOHN (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:LINDSLY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6450 LA HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:BATCHELOR
Mailing Address - State:LA
Mailing Address - Zip Code:70715-3212
Mailing Address - Country:US
Mailing Address - Phone:225-492-3775
Mailing Address - Fax:225-492-3782
Practice Address - Street 1:6450 LA HWY 1
Practice Address - Street 2:
Practice Address - City:INNIS
Practice Address - State:LA
Practice Address - Zip Code:70747-0089
Practice Address - Country:US
Practice Address - Phone:225-492-3775
Practice Address - Fax:225-492-3782
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA19971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1819972Medicaid