Provider Demographics
NPI:1952733065
Name:KALINOSKI, DEBORAH NOELLE (RDH)
Entity Type:Individual
Prefix:MISS
First Name:DEBORAH
Middle Name:NOELLE
Last Name:KALINOSKI
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12325 SW HORIZON BLVD STE 229
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-9475
Mailing Address - Country:US
Mailing Address - Phone:971-205-5822
Mailing Address - Fax:503-590-0300
Practice Address - Street 1:12325 SW HORIZON BLVD STE 229
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-9475
Practice Address - Country:US
Practice Address - Phone:971-205-5822
Practice Address - Fax:503-590-0300
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH6130124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist