Provider Demographics
NPI:1922813450
Name:TATMAN, LINDSAY MARIE (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:MARIE
Last Name:TATMAN
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1747 W 30TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018-3195
Mailing Address - Country:US
Mailing Address - Phone:303-828-8497
Mailing Address - Fax:
Practice Address - Street 1:1747 W 30TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-3195
Practice Address - Country:US
Practice Address - Phone:303-828-8497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1100821223X0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology