Provider Demographics
NPI:1588407845
Name:PAINTER, LYNN (RDH)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:PAINTER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 HEATHER RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-6140
Mailing Address - Country:US
Mailing Address - Phone:530-356-5649
Mailing Address - Fax:
Practice Address - Street 1:4215 FRONT ST
Practice Address - Street 2:
Practice Address - City:SHASTA LAKE
Practice Address - State:CA
Practice Address - Zip Code:96019-9430
Practice Address - Country:US
Practice Address - Phone:530-276-9129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21725124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist