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General NPI Number Information
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NPI Number | 1457102774
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Entity Type | Individual
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Provider Name | JESSICA LEE LINDLER
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Gender | Female
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Dates
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Enumeration Date | 03/27/2024
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 30 AUDREY LN
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City | OXON HILL
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State | MD
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Zip | 20745-1301
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Country | US
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Telephone | 301-567-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 3319 EMILY ST
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City | CASTLE ROCK
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State | CO
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Zip | 80109-3912
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Country | US
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Telephone |
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401419073
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 18468
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License Number State | MD
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