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NPI Code Detail

MEDICARE: LINDSEY KOIDA, DDS, INC

MEDICARE: LINDSEY KOIDA, DDS, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry55075CA

General Provider Information

NPI Number : 1497298657
Entity Type Code : Organization
Provider Name (Legal Business Name) : LINDSEY KOIDA, DDS, INC
Provider Business Mailing Address
First Line : 5700 BROADWAY
Second Line :
City : OAKLAND
State : CA
Zip : 94618-1523
Country : US
Telephone Number : 510-652-1517
Fax Number : 510-653-9088
Provider Business Practice Location Address
First Line : 5700 BROADWAY
Second Line :
City : OAKLAND
State : CA
Zip : 94618-1523
Country : US
Telephone Number : 510-652-1517
Fax Number : 510-653-9088
Authorized Official
Title or Position : PRESIDENT
Name : DR. LINDSEY KOIDA
Credential : DDS
Telephone Number : 510-652-1517
Provider Enumeration Date : 11/21/2016
Last Update Date : 11/21/2016

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Directions to “LINDSEY KOIDA, DDS, INC ” Practice Location

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