Provider Demographics
NPI:1891926929
Name:GREENSTEIN, SAMUEL J (DMD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:J
Last Name:GREENSTEIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12325SWHORIZON BLVD 229
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-9475
Mailing Address - Country:US
Mailing Address - Phone:971-205-5822
Mailing Address - Fax:503-590-0300
Practice Address - Street 1:16155 NW CORNELL RD
Practice Address - Street 2:STE 450
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-4810
Practice Address - Country:US
Practice Address - Phone:503-629-5300
Practice Address - Fax:503-690-9452
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD93231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice