Provider Demographics
NPI:1881759918
Name:EIGNER- BARRY, TONI LEE (DMD)
Entity type:Individual
Prefix:DR
First Name:TONI
Middle Name:LEE
Last Name:EIGNER- BARRY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 N RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1620
Mailing Address - Country:US
Mailing Address - Phone:503-494-6822
Mailing Address - Fax:503-284-1398
Practice Address - Street 1:214 N RUSSELL ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1620
Practice Address - Country:US
Practice Address - Phone:503-494-6822
Practice Address - Fax:503-284-1398
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD5357122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR049171Medicaid
OR000777001OtherREGENCE BCBSO