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General NPI Number Information
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NPI Number | 1548964661
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Entity Type | Individual
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Provider Name | LINDSAY BROOKE PISAN DMD
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Gender | Female
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Dates
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Enumeration Date | 03/30/2023
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 805 NJ-38
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City | CHERRY HILL
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State | NJ
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Zip | 08002
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Country | US
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Telephone | 856-281-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 S BROAD ST APT 734
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City | PHILADELPHIA
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State | PA
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Zip | 19146-2258
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Country | US
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Telephone | 407-616-7636
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DS045069
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS045069
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License Number State | PA
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