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General NPI Number Information
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NPI Number | 1235157181
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Entity Type | Individual
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Provider Name | REBECCA ANN LENOX DMD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3710 SW US VETERANS HOSPITAL RD P-3-DENT
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City | PORTLAND
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State | OR
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Zip | 97239-2964
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Country | US
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Telephone | 503-220-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 19519 SE 10TH ST
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City | CAMAS
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State | WA
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Zip | 98607-7255
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Country | US
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Telephone | 360-817-2426
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 19919
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License Number State | OH
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