Provider Demographics
NPI:1922140649
Name:KIMURA-OPPERMAN, RIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:RIE
Middle Name:
Last Name:KIMURA-OPPERMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:RIE
Other - Middle Name:
Other - Last Name:KIMURA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:9480 SW WEST HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6759
Mailing Address - Country:US
Mailing Address - Phone:503-484-5025
Mailing Address - Fax:
Practice Address - Street 1:7105 SW HAMPTON ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8314
Practice Address - Country:US
Practice Address - Phone:503-684-9274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD8813122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist