Provider Demographics
NPI:1174739627
Name:JENKINS, LINDSAY RACHEL (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:RACHEL
Last Name:JENKINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 EAST OAK STREET
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-1503
Mailing Address - Country:US
Mailing Address - Phone:301-334-3435
Mailing Address - Fax:301-334-3481
Practice Address - Street 1:323 EAST OAK STREET
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1503
Practice Address - Country:US
Practice Address - Phone:301-334-3435
Practice Address - Fax:301-334-3481
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD137361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD012604700Medicaid