Provider Demographics
NPI:1669751889
Name:JOHN DELPLANCHE, DMD, MS, LLC
Entity type:Organization
Organization Name:JOHN DELPLANCHE, DMD, MS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:DELPLANCHE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:503-643-2614
Mailing Address - Street 1:10700 SW BEAVERTON HILLSDALE HWY
Mailing Address - Street 2:SUITE 115
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-3019
Mailing Address - Country:US
Mailing Address - Phone:503-643-2614
Mailing Address - Fax:503-643-9345
Practice Address - Street 1:10700 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:SUITE 115
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3019
Practice Address - Country:US
Practice Address - Phone:503-643-2614
Practice Address - Fax:503-643-9345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD9519261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental