Provider Demographics
NPI:1326150855
Name:AHUMADA-ALANIZ, ABEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ABEL
Middle Name:
Last Name:AHUMADA-ALANIZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13908 SE STARK ST STE E
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-2161
Mailing Address - Country:US
Mailing Address - Phone:503-262-1996
Mailing Address - Fax:503-262-4895
Practice Address - Street 1:13908 SE STARK ST STE E
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-2161
Practice Address - Country:US
Practice Address - Phone:503-262-1996
Practice Address - Fax:503-262-4895
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD86031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice