Provider Demographics
NPI:1699883215
Name:PRASNIKAR, DON LEWIS (DDS)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:LEWIS
Last Name:PRASNIKAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 NE MULTNOMAH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2099
Mailing Address - Country:US
Mailing Address - Phone:503-813-4970
Mailing Address - Fax:503-813-3103
Practice Address - Street 1:500 NE MULTNOMAH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2099
Practice Address - Country:US
Practice Address - Phone:503-813-4970
Practice Address - Fax:503-813-3103
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD55521223G0001X
WADE000047861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice