Provider Demographics
NPI:1508114596
Name:CERBU, DELIA VIORICA (RDH)
Entity Type:Individual
Prefix:MRS
First Name:DELIA
Middle Name:VIORICA
Last Name:CERBU
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 1:15105 SW 98TH AVE
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-4709
Mailing Address - Country:US
Mailing Address - Phone:503-998-9290
Mailing Address - Fax:
Practice Address - Street 1:15105 SW 98TH AVE
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-4709
Practice Address - Country:US
Practice Address - Phone:503-998-9290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-22
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH6239124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist