Provider Demographics
NPI:1326032715
Name:REED, DENNIS EATON (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:EATON
Last Name:REED
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 1:9876 SW PEPPERTREE LN
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-4787
Mailing Address - Country:US
Mailing Address - Phone:503-620-1647
Mailing Address - Fax:
Practice Address - Street 1:19731 HIGHWAY 213
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4190
Practice Address - Country:US
Practice Address - Phone:503-656-7888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD53351223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics