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General NPI Number Information
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NPI Number | 1588477368
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Entity Type | Individual
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Provider Name | AUDREY DINH RDH
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Gender | Female
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 2606 NE BROADWAY ST STE A
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City | PORTLAND
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State | OR
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Zip | 97232-1898
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Country | US
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Telephone | 503-595-5463
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Fax |
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Provider Business Mailing Address
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Address Line | 14568 SE POPPY HILLS DR
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City | HAPPY VALLEY
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State | OR
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Zip | 97086-7323
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Country | US
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Telephone | 503-740-9333
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | H4578
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License Number State | OR
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