Healthcare Provider Details

I. General information

NPI: 1881769719
Provider Name (Legal Business Name): PAUL WASHINGTON LINDO D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1922 HIGHWAY 74 N STE E
TYRONE GA
30290-1660
US

IV. Provider business mailing address

1922 HIGHWAY 74 N STE E
TYRONE GA
30290-1660
US

V. Phone/Fax

Practice location:
  • Phone: 770-892-2110
  • Fax: 770-892-2126
Mailing address:
  • Phone: 770-892-2110
  • Fax: 770-892-2126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN011348
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: