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General NPI Number Information
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NPI Number | 1578376323
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Entity Type | Organization
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Legal Business Name | LINDSAY COSTANTINO, DDS INC
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 10505 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90064-2319
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Country | US
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Telephone | 310-475-0617
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Fax | 310-474-5255
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Provider Business Mailing Address
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Address Line | 10505 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90064-2319
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Country | US
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Telephone | 310-475-0617
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Fax | 310-474-5255
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. LINDSAY COSTANTINO
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Credential | DDS
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Telephone | 310-475-0617
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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 |
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License Number State |
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