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NPI Code Detail

MEDICARE: LAKEWOOD DENTAL ARTS-EDWARD A HADAWAY DDS& DENVER D JENKINS JR DDS LLC

MEDICARE: LAKEWOOD DENTAL ARTS-EDWARD A HADAWAY DDS& DENVER D JENKINS JR DDS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist

General Provider Information

NPI Number : 1134294150
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKEWOOD DENTAL ARTS-EDWARD A HADAWAY DDS& DENVER D JENKINS JR DDS LLC
Provider Business Mailing Address
First Line : 17117 DETROIT AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-3622
Country : US
Telephone Number : 216-221-3368
Fax Number : 216-221-3371
Provider Business Practice Location Address
First Line : 17117 DETROIT AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-3622
Country : US
Telephone Number : 216-221-3368
Fax Number : 216-221-3371
Authorized Official
Title or Position : OFFICE MANAGER
Name : DR. EDWARD A HADAWAY
Credential :
Telephone Number : 216-221-3368
Provider Enumeration Date : 11/22/2006
Last Update Date : 07/10/2008

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Directions to “LAKEWOOD DENTAL ARTS-EDWARD A HADAWAY DDS& DENVER D JENKINS JR DDS LLC ” Practice Location

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