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NPI Code Detail

MEDICARE: DR. JON J. LINDENMEYER DDS

MEDICARE: DR. JON J. LINDENMEYER DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryM689SD

General Provider Information

NPI Number : 1073684163
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JON J. LINDENMEYER DDS
Provider Business Mailing Address
First Line : 1611 SHERIDAN LAKE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-3423
Country : US
Telephone Number : 605-341-3670
Fax Number :
Provider Business Practice Location Address
First Line : 1611 SHERIDAN LAKE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-3423
Country : US
Telephone Number : 605-341-3670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 07/08/2007

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