Provider Demographics
NPI:1699316968
Name:AQUINO, LENIN J (DMD)
Entity type:Individual
Prefix:DR
First Name:LENIN
Middle Name:J
Last Name:AQUINO
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 1:204 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MOLALLA
Mailing Address - State:OR
Mailing Address - Zip Code:97038-9117
Mailing Address - Country:US
Mailing Address - Phone:971-255-6330
Mailing Address - Fax:
Practice Address - Street 1:2020 SE 182ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-5692
Practice Address - Country:US
Practice Address - Phone:503-988-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD111371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice