Provider Demographics
NPI:1114118536
Name:LOCKWOOD, JEFFREY LYND (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LYND
Last Name:LOCKWOOD
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 1:6817 N CEDAR RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-4277
Mailing Address - Country:US
Mailing Address - Phone:509-327-4469
Mailing Address - Fax:509-328-9902
Practice Address - Street 1:6817 N CEDAR RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-4277
Practice Address - Country:US
Practice Address - Phone:509-327-4469
Practice Address - Fax:509-328-9902
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000106571223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics