Provider Demographics
NPI:1942425632
Name:DIXON, KATHRYN E (DMD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:E
Last Name:DIXON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15839 SW BLUEWATER TER
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-2288
Mailing Address - Country:US
Mailing Address - Phone:541-880-8090
Mailing Address - Fax:
Practice Address - Street 1:15839 SW BLUEWATER TER
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-2288
Practice Address - Country:US
Practice Address - Phone:541-880-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD78131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice