Provider Demographics
NPI:1942490560
Name:PEARSON, JEFFREY JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JAMES
Last Name:PEARSON
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 1:4215 198TH ST SW
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6738
Mailing Address - Country:US
Mailing Address - Phone:425-775-3427
Mailing Address - Fax:425-673-5337
Practice Address - Street 1:4215 198TH ST SW
Practice Address - Street 2:SUITE 203
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6738
Practice Address - Country:US
Practice Address - Phone:425-775-3427
Practice Address - Fax:425-673-5337
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000110631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice