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General NPI Number Information
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NPI Number | 1598047003
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Entity Type | Individual
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Provider Name | JOHN M LINDELL DDS
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Gender | Male
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Dates
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Enumeration Date | 09/12/2011
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 5021 WASHINGTON RD
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City | KENOSHA
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State | WI
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Zip | 53144-4292
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Country | US
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Telephone | 262-632-5455
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Fax |
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Provider Business Mailing Address
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Address Line | 1209 VALLEY VIEW DR
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City | MT PLEASANT
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State | WI
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Zip | 53405-1738
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Country | US
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Telephone | 775-336-9198
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019028840
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 600005015
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License Number State | WI
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