Provider Demographics
NPI:1790668549
Name:CHAPMAN, AUSTIN ROBERT (LD)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:ROBERT
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 12TH ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1538
Mailing Address - Country:US
Mailing Address - Phone:541-386-2012
Mailing Address - Fax:
Practice Address - Street 1:926 12TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1538
Practice Address - Country:US
Practice Address - Phone:541-386-2012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDT-DO-10258528122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist