Provider Demographics
NPI:1942826227
Name:BAKOS, CYNTHIA (RDH)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:BAKOS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:HAYEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:849 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1956
Mailing Address - Country:US
Mailing Address - Phone:541-308-8308
Mailing Address - Fax:541-308-0754
Practice Address - Street 1:1040 WEBBER ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-3749
Practice Address - Country:US
Practice Address - Phone:541-386-6380
Practice Address - Fax:541-308-0754
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH6114124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORH6114OtherSTATE LICENSE