MEDICARE: DR. TODD ESAU

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
1	122300000X	Dentist	6754	KS

General Provider Information

NPI Number	:	1518083377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. TODD ESAU

Provider Business Mailing Address
First Line	:	1716 E 23RD AVE
Second Line	:
City	:	HUTCHINSON
State	:	KS
Zip	:	67502-1114
Country	:	US
Telephone Number	:	620-662-3807
Fax Number	:	620-662-5160

Provider Business Practice Location Address
First Line	:	1716 E 23RD AVE
Second Line	:
City	:	HUTCHINSON
State	:	KS
Zip	:	67502-1114
Country	:	US
Telephone Number	:	620-662-3807
Fax Number	:	620-662-5160

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. TODD A ESAU
Credential	:	DDS
Telephone Number	:	620-662-3807

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	08/22/2020

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