MEDICARE: DR. THOMAS B DODSON DMD

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DE60386478	WA
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	7885	CO
3	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	15548	MA
4	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	34606	CA
5	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	010950	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	015548	OTHER	MA	TUFTS HEALTH PLAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	X07675	OTHER	MA	BCBS MA

General Provider Information

NPI Number	:	1629050653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS B DODSON DMD

Provider Business Mailing Address
First Line	:	1959 NE PACIFIC ST
Second Line	:	BOX 357134
City	:	SEATTLE
State	:	WA
Zip	:	98195-0001
Country	:	US
Telephone Number	:	206-543-5860
Fax Number	:	206-616-7251

Provider Business Practice Location Address
First Line	:	6222 NE 74TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-8158
Country	:	US
Telephone Number	:	206-543-5860
Fax Number	:	206-685-7222

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	10/23/2025

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