Provider Demographics
NPI:1548657448
Name:LINDLEY, RICKIE RENEE (RDH, BS, NCPT)
Entity type:Individual
Prefix:
First Name:RICKIE
Middle Name:RENEE
Last Name:LINDLEY
Suffix:
Gender:F
Credentials:RDH, BS, NCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 BARDFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-4916
Mailing Address - Country:US
Mailing Address - Phone:972-922-1881
Mailing Address - Fax:469-283-2688
Practice Address - Street 1:2702 LAKE VISTA DR. SUIT 1
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067
Practice Address - Country:US
Practice Address - Phone:972-459-7070
Practice Address - Fax:469-283-2688
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18478124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist