Provider Demographics
NPI:1588477368
Name:DINH, AUDREY (RDH)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:DINH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14568 SE POPPY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-7323
Mailing Address - Country:US
Mailing Address - Phone:503-740-9333
Mailing Address - Fax:
Practice Address - Street 1:2606 NE BROADWAY ST STE A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1898
Practice Address - Country:US
Practice Address - Phone:503-595-5463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH4578124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist