Provider Demographics
NPI:1588676423
Name:DODSON, JEFFREY DUNN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DUNN
Last Name:DODSON
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 1:11311 14TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6313
Mailing Address - Country:US
Mailing Address - Phone:206-363-1156
Mailing Address - Fax:206-362-6059
Practice Address - Street 1:11311 14TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6313
Practice Address - Country:US
Practice Address - Phone:206-363-1156
Practice Address - Fax:206-362-6059
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000048651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice