Provider Demographics
NPI:1922000728
Name:LOCKETT, STEVEN C (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:C
Last Name:LOCKETT
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 1:10254 16TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98146-1432
Mailing Address - Country:US
Mailing Address - Phone:206-762-2573
Mailing Address - Fax:206-763-0291
Practice Address - Street 1:10254 16TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98146-1432
Practice Address - Country:US
Practice Address - Phone:206-762-2573
Practice Address - Fax:206-763-0291
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
WA5589122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist