Provider Demographics
NPI:1578976387
Name:PARKER, LAWSON BRANCH (DMD)
Entity Type:Individual
Prefix:
First Name:LAWSON
Middle Name:BRANCH
Last Name:PARKER
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 1:7701 W 119TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1103
Mailing Address - Country:US
Mailing Address - Phone:913-529-5999
Mailing Address - Fax:
Practice Address - Street 1:7701 W 119TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1103
Practice Address - Country:US
Practice Address - Phone:913-529-5999
Practice Address - Fax:913-529-5995
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KS617601223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program