Healthcare Provider Details

I. General information

NPI: 1679551881
Provider Name (Legal Business Name): KERRI LYN LAWLOR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 11/04/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10107 RIDGEGATE PKWY STE G020
LONE TREE CO
80124-5637
US

IV. Provider business mailing address

10107 RIDGEGATE PKWY STE G020
LONE TREE CO
80124-5637
US

V. Phone/Fax

Practice location:
  • Phone: 720-507-2241
  • Fax: 720-507-2221
Mailing address:
  • Phone: 720-507-2241
  • Fax: 720-507-2221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number60009
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number9815
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: