Provider Demographics
NPI:1073709499
Name:LANGE, ERIN MARGARET (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MARGARET
Last Name:LANGE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:SCHEMINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9615 GRAND RONDE RD
Mailing Address - Street 2:
Mailing Address - City:GRAND RONDE
Mailing Address - State:OR
Mailing Address - Zip Code:97347-9712
Mailing Address - Country:US
Mailing Address - Phone:503-879-2020
Mailing Address - Fax:503-879-2414
Practice Address - Street 1:9615 GRAND RONDE RD
Practice Address - Street 2:
Practice Address - City:GRAND RONDE
Practice Address - State:OR
Practice Address - Zip Code:97347-9712
Practice Address - Country:US
Practice Address - Phone:503-879-2020
Practice Address - Fax:503-879-2414
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD8954122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist