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General NPI Number Information
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NPI Number | 1235491713
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Entity Type | Individual
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Provider Name | LYNDSEY C JONES SANDIFER D.M.D., M.S.D
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Gender | Female
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 05/29/2013
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Provider Practice Location Address
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Address Line | 219 GARDEN PARK DR SUITE 100
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City | MADISON
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State | MS
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Zip | 39110-5511
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Country | US
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Telephone | 601-853-1307
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Fax | 601-853-9872
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Provider Business Mailing Address
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Address Line | 219 GARDEN PARK DR SUITE 100
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City | MADISON
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State | MS
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Zip | 39110-5511
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Country | US
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Telephone | 601-853-1307
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Fax | 601-853-9872
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3544-10
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | OR-458-12
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License Number State | MS
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