Provider Demographics
NPI:1245223189
Name:NEWKIRK, ANTHONY JAMES (DMD RPH)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JAMES
Last Name:NEWKIRK
Suffix:
Gender:M
Credentials:DMD RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0224 SW HAMILTON ST
Mailing Address - Street 2:STE 201
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-6418
Mailing Address - Country:US
Mailing Address - Phone:503-228-4142
Mailing Address - Fax:503-224-9283
Practice Address - Street 1:0224 SW HAMILTON ST
Practice Address - Street 2:STE 201
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-6418
Practice Address - Country:US
Practice Address - Phone:503-228-4142
Practice Address - Fax:503-224-9283
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR69681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice