Provider Demographics
NPI:1821161241
Name:TROTMAN, RONDA LOUISE (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONDA
Middle Name:LOUISE
Last Name:TROTMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:RONDA
Other - Middle Name:
Other - Last Name:TROTTMAN-REESE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:6950 NE CAMPUS WAY
Mailing Address - Street 2:WILLAMETTE DENTAL GROUP
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124
Mailing Address - Country:US
Mailing Address - Phone:885-433-6825
Mailing Address - Fax:
Practice Address - Street 1:7095 SW GONZAGA ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8309
Practice Address - Country:US
Practice Address - Phone:503-620-6715
Practice Address - Fax:503-620-4013
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD71971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice