Healthcare Provider Details

I. General information

NPI: 1922813450
Provider Name (Legal Business Name): LINDSAY MARIE TATMAN DMD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1747 W 30TH ST
LOS ANGELES CA
90018-3195
US

IV. Provider business mailing address

1747 W 30TH ST
LOS ANGELES CA
90018-3195
US

V. Phone/Fax

Practice location:
  • Phone: 303-828-8497
  • Fax:
Mailing address:
  • Phone: 303-828-8497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License NumberDDS110082
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: