Provider Demographics
NPI:1821778127
Name:MCCARTHY, HANNAH (DMD)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:
Last Name:MCCARTHY
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 1:3209 SW TALBOT RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-1673
Mailing Address - Country:US
Mailing Address - Phone:541-815-9372
Mailing Address - Fax:
Practice Address - Street 1:20516 ROBAL LN STE 100
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6703
Practice Address - Country:US
Practice Address - Phone:541-815-9372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD11834122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist