Provider Demographics
NPI:1275218042
Name:FIGUEROA, DESSA LEANN
Entity Type:Individual
Prefix:
First Name:DESSA
Middle Name:LEANN
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 JENNINGS ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-3437
Mailing Address - Country:US
Mailing Address - Phone:541-401-7213
Mailing Address - Fax:
Practice Address - Street 1:717 GEARY ST SE STE 102
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-4822
Practice Address - Country:US
Practice Address - Phone:541-924-1086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH4557124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist