Provider Demographics
NPI:1366828014
Name:RHODA LOCKETT, DDS, PC
Entity Type:Organization
Organization Name:RHODA LOCKETT, DDS, PC
Other - Org Name:LOCKETT ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RHODA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:240-338-2518
Mailing Address - Street 1:3210 E WOODMEN RD
Mailing Address - Street 2:SUITE 200B
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3588
Mailing Address - Country:US
Mailing Address - Phone:719-358-6998
Mailing Address - Fax:719-358-6952
Practice Address - Street 1:3210 E WOODMEN RD
Practice Address - Street 2:SUITE 200B
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3588
Practice Address - Country:US
Practice Address - Phone:719-358-6998
Practice Address - Fax:719-358-6952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO98001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty