Provider Demographics
NPI:1154354686
Name:LAZAR, LAUREN K (DDS)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:K
Last Name:LAZAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8632 NE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:WA
Mailing Address - Zip Code:98039-3915
Mailing Address - Country:US
Mailing Address - Phone:206-679-0887
Mailing Address - Fax:
Practice Address - Street 1:1530 BELLEVUE WAY SE STE A
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-7110
Practice Address - Country:US
Practice Address - Phone:425-454-4963
Practice Address - Fax:425-454-0819
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000085291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice