Healthcare Provider Details

I. General information

NPI: 1770938474
Provider Name (Legal Business Name): LINDIWE COSTER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2016
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 JOHN A CUMMINGS WAY
WOONSOCKET RI
02895-3244
US

IV. Provider business mailing address

25 JOHN A CUMMINGS WAY
WOONSOCKET RI
02895-3244
US

V. Phone/Fax

Practice location:
  • Phone: 401-767-4161
  • Fax:
Mailing address:
  • Phone: 401-767-4161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1857290
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN03346
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: