Provider Demographics
NPI:1013037399
Name:PEARSON, TODD B (DDS)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:B
Last Name:PEARSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ORINDA WAY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563
Mailing Address - Country:US
Mailing Address - Phone:925-254-2360
Mailing Address - Fax:925-254-7392
Practice Address - Street 1:23 ORINDA WAY
Practice Address - Street 2:SUITE 301
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563
Practice Address - Country:US
Practice Address - Phone:925-254-2360
Practice Address - Fax:925-254-7392
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA466681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice