Provider Demographics
NPI:1376837187
Name:OSSINGER, ANN LYNNE (RDH)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:LYNNE
Last Name:OSSINGER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 SW ROTH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-1553
Mailing Address - Country:US
Mailing Address - Phone:541-757-0742
Mailing Address - Fax:
Practice Address - Street 1:1815 SW ROTH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-1553
Practice Address - Country:US
Practice Address - Phone:541-757-0742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH5882124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist