Provider Demographics
NPI:1295420446
Name:CAMAS PERIODONTICS
Entity type:Organization
Organization Name:CAMAS PERIODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DUY ANH
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-380-5872
Mailing Address - Street 1:12934 SW HILLSIDE TER
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-1908
Mailing Address - Country:US
Mailing Address - Phone:360-818-2232
Mailing Address - Fax:360-818-2261
Practice Address - Street 1:14780 SW OSPREY DR STE 240A
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-8424
Practice Address - Country:US
Practice Address - Phone:503-747-0095
Practice Address - Fax:503-747-0027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental