Provider Demographics
NPI:1649212515
Name:SINHA, RAVI S (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:S
Last Name:SINHA
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 1:1238 SE 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-1202
Mailing Address - Country:US
Mailing Address - Phone:503-255-6815
Mailing Address - Fax:503-255-3044
Practice Address - Street 1:1238 SE 122ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-1202
Practice Address - Country:US
Practice Address - Phone:503-255-6815
Practice Address - Fax:503-255-3044
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD76521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice