Provider Demographics
NPI:1932233483
Name:WENDLING, SUE E (DMD)
Entity Type:Individual
Prefix:DR
First Name:SUE
Middle Name:E
Last Name:WENDLING
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 1:17437 SW BOONES FERRY RD SUITE 400
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035
Mailing Address - Country:US
Mailing Address - Phone:503-636-4069
Mailing Address - Fax:503-636-3138
Practice Address - Street 1:17437 SW BOONES FERRY RD
Practice Address - Street 2:SUITE 400
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035
Practice Address - Country:US
Practice Address - Phone:503-636-4069
Practice Address - Fax:503-636-3138
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD66481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice