Provider Demographics
NPI:1962917724
Name:DRENNAN, CHERYL ANN (RDH, BSDH)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:DRENNAN
Suffix:
Gender:F
Credentials:RDH, BSDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13026 SE CREEKSIDE TER
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-6232
Mailing Address - Country:US
Mailing Address - Phone:503-502-3481
Mailing Address - Fax:
Practice Address - Street 1:9300 SE 91ST AVE STE 310
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-3762
Practice Address - Country:US
Practice Address - Phone:503-813-2000
Practice Address - Fax:503-772-7885
Is Sole Proprietor?:No
Enumeration Date:2017-12-02
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH6061124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORH6061OtherOREGON BOARD OF DENTISTRY