Healthcare Provider Details

I. General information

NPI: 1073402459
Provider Name (Legal Business Name): DALENA MAI THI HUONG HA HA DMD, MS, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 SE 88TH AVE
PORTLAND OR
97266-2396
US

IV. Provider business mailing address

PO BOX 190
TOPPENISH WA
98948-0190
US

V. Phone/Fax

Practice location:
  • Phone: 503-772-4335
  • Fax: 503-772-8740
Mailing address:
  • Phone: 509-865-2395
  • Fax: 509-865-0757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD12395
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: