Provider Demographics
NPI:1487771986
Name:GARFINKLE, JUDAH (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:JUDAH
Middle Name:
Last Name:GARFINKLE
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 SW SUNSET BLVD
Mailing Address - Street 2:SU. G
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-2641
Mailing Address - Country:US
Mailing Address - Phone:503-246-9802
Mailing Address - Fax:
Practice Address - Street 1:1820 SW VERMONT ST STE O
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-1945
Practice Address - Country:US
Practice Address - Phone:503-246-9802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD81951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics