Provider Demographics
NPI:1750811485
Name:LASSEN, STEFFEN NIELS (DDS)
Entity type:Individual
Prefix:DR
First Name:STEFFEN
Middle Name:NIELS
Last Name:LASSEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4120 QUEST DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-8768
Mailing Address - Country:US
Mailing Address - Phone:541-688-7278
Mailing Address - Fax:541-334-6604
Practice Address - Street 1:4120 QUEST DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-8768
Practice Address - Country:US
Practice Address - Phone:541-688-7278
Practice Address - Fax:541-334-6604
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101423122300000X
ORD109801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist