# LYDIAN DENTAL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851871487
- **Authorized official:** PAMELYN D BUCKHANAN (INSURANCE COORDINATOR)
- **Authorized official phone:** (480) 899-7996

## Contact information

- **Practice address:** 2010 E ELLIOT RD STE 105, TEMPE, AZ 85284-1790
- **Practice address phone:** (480) 899-7996
- **Practice address fax:** (480) 752-3231
- **Mailing address:** 2010 E ELLIOT RD STE 105, TEMPE, AZ 85284-1790
- **Mailing address phone:** (480) 899-7996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D6107 | AZ | Yes |

## Other

- **Enumeration date:** 08/14/2018
- **Last updated:** 08/14/2018