Healthcare Provider Details

I. General information

NPI: 1205202397
Provider Name (Legal Business Name): LYNDSAY MARKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2015
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3140 FLORIDA ST
BATON ROUGE LA
70806-3757
US

IV. Provider business mailing address

3140 FLORIDA ST
BATON ROUGE LA
70806-3757
US

V. Phone/Fax

Practice location:
  • Phone: 225-478-1174
  • Fax:
Mailing address:
  • Phone: 225-478-1174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7270
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3896-16
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: