Provider Demographics
NPI:1568834273
Name:LOWE, DAWN ELAINE (RDH)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:ELAINE
Last Name:LOWE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:ELAINE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:30489 BERLIN RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-9730
Mailing Address - Country:US
Mailing Address - Phone:541-510-1424
Mailing Address - Fax:
Practice Address - Street 1:2040 S SANTIAM HWY
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-3042
Practice Address - Country:US
Practice Address - Phone:541-451-3394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDH0016125J00000X
ORH7036124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
No125J00000XDental ProvidersDental Therapist