Healthcare Provider Details

I. General information

NPI: 1053301986
Provider Name (Legal Business Name): MICHAEL SHAWN LAWLER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9896 ROSEMONT AVE STE. 103
LONE TREE CO
80124-4104
US

IV. Provider business mailing address

9896 ROSEMONT AVE STE. 103
LONE TREE CO
80124-4104
US

V. Phone/Fax

Practice location:
  • Phone: 303-705-5700
  • Fax: 303-705-9729
Mailing address:
  • Phone: 303-705-5700
  • Fax: 303-705-9729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8712
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4572
License Number StateNV

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: