Provider Demographics
NPI:1720762529
Name:TAWADROS, LOREEN (DDS)
Entity type:Individual
Prefix:
First Name:LOREEN
Middle Name:
Last Name:TAWADROS
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 1:731 SOUTHBRIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-4371
Mailing Address - Country:US
Mailing Address - Phone:440-221-8654
Mailing Address - Fax:
Practice Address - Street 1:8475 MEMPHIS AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44144-2135
Practice Address - Country:US
Practice Address - Phone:216-661-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2025-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0274451223G0001X
TX397311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice