Provider Demographics
NPI:1639987902
Name:LOTITO, LINDSEY (RDH, OMT, LEC)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:
Last Name:LOTITO
Suffix:
Gender:F
Credentials:RDH, OMT, LEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 S BAY ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29440-4262
Mailing Address - Country:US
Mailing Address - Phone:843-344-9706
Mailing Address - Fax:
Practice Address - Street 1:2506 S BAY ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-4262
Practice Address - Country:US
Practice Address - Phone:843-344-9706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC7419125J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes125J00000XDental ProvidersDental Therapist