Healthcare Provider Details

I. General information

NPI: 1275125221
Provider Name (Legal Business Name): LINDSAY ESSENMACHER DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2021
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8310 PALOMAS AVE NE STE C
ALBUQUERQUE NM
87109-5286
US

IV. Provider business mailing address

8310 PALOMAS AVE NE STE C
ALBUQUERQUE NM
87109-5286
US

V. Phone/Fax

Practice location:
  • Phone: 505-881-0334
  • Fax:
Mailing address:
  • Phone: 505-881-0334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ANGELA BARELA
Title or Position: OFFICE MANAGER
Credential:
Phone: 505-881-0334