Provider Demographics
NPI:1164641593
Name:V2 DENTISTRY, PC
Entity Type:Organization
Organization Name:V2 DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:VAN VOORHIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:503-393-2651
Mailing Address - Street 1:4575 RIVER RD N
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-4645
Mailing Address - Country:US
Mailing Address - Phone:503-393-2651
Mailing Address - Fax:503-393-1766
Practice Address - Street 1:4575 RIVER RD N
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-4645
Practice Address - Country:US
Practice Address - Phone:503-393-2651
Practice Address - Fax:503-393-1766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD7405122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty