Provider Demographics
NPI:1063578763
Name:DUNCAN, JOHN ALEX (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALEX
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8565 SW BEAVERTON HILLSDALE HWY
Mailing Address - Street 2:SUITE #4
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225
Mailing Address - Country:US
Mailing Address - Phone:503-296-7810
Mailing Address - Fax:503-297-1442
Practice Address - Street 1:8565 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:SUITE #4
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225
Practice Address - Country:US
Practice Address - Phone:503-296-7810
Practice Address - Fax:503-297-1442
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD51591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice