Provider Demographics
NPI:1285113647
Name:HAWKINS, HILLARY GRACE (DDS)
Entity type:Individual
Prefix:DR
First Name:HILLARY
Middle Name:GRACE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10260 SE IDLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-6933
Mailing Address - Country:US
Mailing Address - Phone:503-334-7738
Mailing Address - Fax:
Practice Address - Street 1:13329 SE MISTY DR
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-9303
Practice Address - Country:US
Practice Address - Phone:503-698-5525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD108291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice