Provider Demographics
NPI:1770683393
Name:ESAU, TODD A (DDS)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:A
Last Name:ESAU
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 1:1716 E 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1114
Mailing Address - Country:US
Mailing Address - Phone:620-662-3807
Mailing Address - Fax:620-662-5160
Practice Address - Street 1:1716 E 23RD AVE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1114
Practice Address - Country:US
Practice Address - Phone:620-662-3807
Practice Address - Fax:620-662-5160
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS67541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS17286OtherBCBS