Provider Demographics
NPI:1114934338
Name:LAWSON, TODD S (DMD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:S
Last Name:LAWSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 102ND AVE SE APT 217
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6165
Mailing Address - Country:US
Mailing Address - Phone:425-455-2424
Mailing Address - Fax:425-462-7395
Practice Address - Street 1:1418 112TH AVE NE STE 200
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3718
Practice Address - Country:US
Practice Address - Phone:425-455-2424
Practice Address - Fax:425-462-7395
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000106301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice