Healthcare Provider Details

I. General information

NPI: 1841794369
Provider Name (Legal Business Name): LINDSAY NICOLE RUTHERFORD DMD, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 WESTCHESTER AVE STE 306
PURCHASE NY
10577-2524
US

IV. Provider business mailing address

3010 WESTCHESTER AVE STE 306
PURCHASE NY
10577-2524
US

V. Phone/Fax

Practice location:
  • Phone: 914-253-9088
  • Fax:
Mailing address:
  • Phone: 914-253-9088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number14699
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number061669
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number333355
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: