Provider Demographics
NPI:1952761041
Name:HI 5 ORTHODONTICS
Entity Type:Organization
Organization Name:HI 5 ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAI
Authorized Official - Middle Name:T
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-642-1535
Mailing Address - Street 1:18325 SW ALEXANDER
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97003
Mailing Address - Country:US
Mailing Address - Phone:503-642-1535
Mailing Address - Fax:503-649-2286
Practice Address - Street 1:18325 SW ALEXANDER
Practice Address - Street 2:SUITE 2
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97003
Practice Address - Country:US
Practice Address - Phone:503-642-1535
Practice Address - Fax:503-649-2286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD87751223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty