Provider Demographics
NPI:1275111064
Name:LABINPUNO, VINCE REYNIELLE NITO (DDS)
Entity Type:Individual
Prefix:
First Name:VINCE REYNIELLE
Middle Name:NITO
Last Name:LABINPUNO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4817 RIVER RD N
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-4537
Mailing Address - Country:US
Mailing Address - Phone:503-874-4560
Mailing Address - Fax:
Practice Address - Street 1:4817 RIVER RD N
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-4537
Practice Address - Country:US
Practice Address - Phone:503-874-4560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD117711223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry