Provider Demographics
NPI:1083816169
Name:THE DENTISTS AT ORENCO STATION
Entity type:Organization
Organization Name:THE DENTISTS AT ORENCO STATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:KEARBEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:503-640-4262
Mailing Address - Street 1:1322 NE ORENCO STATION PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5411
Mailing Address - Country:US
Mailing Address - Phone:503-640-4262
Mailing Address - Fax:
Practice Address - Street 1:1322 NE ORENCO STATION PKWY STE 300
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5411
Practice Address - Country:US
Practice Address - Phone:503-640-4262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD9648261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental