Provider Demographics
NPI:1881118982
Name:HUNJAN, ISHA (DDS)
Entity type:Individual
Prefix:DR
First Name:ISHA
Middle Name:
Last Name:HUNJAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15015 NW PERIMETER DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-5415
Mailing Address - Country:US
Mailing Address - Phone:661-520-7994
Mailing Address - Fax:
Practice Address - Street 1:2111 NE 25TH AVE # JF5
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5961
Practice Address - Country:US
Practice Address - Phone:503-991-2351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS101332122300000X
ORD11256122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist