Healthcare Provider Details

I. General information

NPI: 1598044802
Provider Name (Legal Business Name): JOHN F DELPLANCHE DMD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2011
Last Update Date: 08/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 SW BEAVERTON HILLSDALE HWY SUITE 115
BEAVERTON OR
97005-3019
US

IV. Provider business mailing address

10700 SW BEAVERTON HILLSDALE HWY SUITE 115
BEAVERTON OR
97005-3019
US

V. Phone/Fax

Practice location:
  • Phone: 503-643-2614
  • Fax: 503-643-9345
Mailing address:
  • Phone: 503-643-2614
  • Fax: 503-643-9345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberD9519
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: