Provider Demographics
NPI:1346472164
Name:TRAXLER, ANDREW BRYAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:BRYAN
Last Name:TRAXLER
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 1:15945 NE 85TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3531
Mailing Address - Country:US
Mailing Address - Phone:425-885-1113
Mailing Address - Fax:425-861-7154
Practice Address - Street 1:15945 NE 85TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3531
Practice Address - Country:US
Practice Address - Phone:425-885-1113
Practice Address - Fax:425-861-7154
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 000095511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice