Derek W. Conklin Dmd Pc

LBN: Derek W. Conklin Dmd Pc
Derek W. Conklin Dmd Pc is an health care organization with primary practice located at 17471 Shelley Ave Ste A , Sandy OR 97055-8084. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Derek W. Conklin Dmd Pc can be contacted via phone (503) 668-4655, or through Conklin, Derek W. via phone (503) 668-4655.

Contact Information

Primary practice address
17471 Shelley Ave Ste A Sandy OR 97055-8084
Phone: (503) 668-4655
Fax: (503) 668-8755
Website:
Map and Directions
Authorized official contact:
Name: Conklin, Derek W. Doctor of Dental Medicine (DMD)
Phone: (503) 668-4655

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X D8325 Oregon

Profile Details

NPI number 1558635391
LBN Legal business name Derek W. Conklin Dmd Pc
DBA Doing business as
Authorized official Conklin, Derek W. Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 24th, 2012
Last updated Feb 24th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558635391 NPPES
Oregon MEDICAID 243185

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