Provider Demographics
NPI:1003433251
Name:MERIDIAN ENDODONTICS, PLLC
Entity Type:Organization
Organization Name:MERIDIAN ENDODONTICS, PLLC
Other - Org Name:RIDGEGATE ENDODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAWLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-507-2239
Mailing Address - Street 1:10107 RIDGEGATE PKWY # G020
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5637
Mailing Address - Country:US
Mailing Address - Phone:720-507-2221
Mailing Address - Fax:
Practice Address - Street 1:10107 RIDGEGATE PKWY # G020
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5637
Practice Address - Country:US
Practice Address - Phone:720-507-2221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty