Sandra J. Bennett, DMD
Individual provider Active NPI General Practice Dentistry · Gresham, OR
NPI 1932157609 · NPPES record last updated Apr 24, 2008
Key facts
- NPI
- 1932157609
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D7351 (OR)
- Practice address
- 22400 SE Stark St
Gresham, OR 97030-2656 - Phone
- (503) 667-0438
- Fax
- (503) 665-4870
- NPI assigned
- May 5, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7351 | OR | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D7351 | OR | Yes |
Addresses
Primary practice location
22400 SE Stark St
Gresham, OR 97030-2656
Mailing address
22400 SE Stark St
Gresham, OR 97030-2656
Phone (503) 667-0438
Other providers in Gresham, OR
- Jennifer Beltran
- Benchmark Physical Therapy of Or, LLC
- Marin Benfit
- Benjamin T Russell DMD LLC
- Linda Gail Bennett
- Ramon Benton
- Amy E Berg
- Daniel R Berger
- Robert W Bergstrom
- Lily Bradenrose Berlstein
All providers in Gresham, OR · General Practice Dentistry in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.