Provider Demographics
NPI:1992971477
Name:HANS, LINDSEY A (DMD)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:A
Last Name:HANS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2918 CROSSING CT STE A
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-6100
Mailing Address - Country:US
Mailing Address - Phone:217-356-9855
Mailing Address - Fax:217-356-9750
Practice Address - Street 1:2918 CROSSING CT STE A
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-6100
Practice Address - Country:US
Practice Address - Phone:217-356-9855
Practice Address - Fax:217-356-9750
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL01902786332B00000X
IL019027486122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies