Provider Demographics
NPI:1811204233
Name:ESTEP, ERIN N (DMD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:N
Last Name:ESTEP
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 J ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-4252
Mailing Address - Country:US
Mailing Address - Phone:541-515-6631
Mailing Address - Fax:541-654-5363
Practice Address - Street 1:1611 J ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-4252
Practice Address - Country:US
Practice Address - Phone:541-515-6631
Practice Address - Fax:541-654-5363
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD96801223P0221X
CA61444122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223P0221XDental ProvidersDentistPediatric Dentistry