Healthcare Provider Details

I. General information

NPI: 1497524672
Provider Name (Legal Business Name): COLLINS DENTAL ORTHO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2023
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 PEOPLES PLZ
NEWARK DE
19702-4727
US

IV. Provider business mailing address

38 PEOPLES PLZ
NEWARK DE
19702-4727
US

V. Phone/Fax

Practice location:
  • Phone: 302-834-4000
  • Fax: 302-834-1417
Mailing address:
  • Phone: 302-834-4000
  • Fax: 302-834-1417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. LYNN MARIE COLLINS
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 302-834-4275