| Andrew Sype Dmd, Pc | |
|
12758 Se Stark St Ste D Portland OR 97233-1539 | |
| (503) 760-3214 | |
| (503) 719-5343 |
| Full Name | Andrew Sype Dmd, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 12758 Se Stark St Ste D, Portland, Oregon |
| Authorized Official Name and Position | Leanne Sype (ADMINISTRATION) |
| Authorized Official Contact | 5035447091 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew Sype Dmd, Pc 12758 Se Stark St Ste D Portland OR 97233-1539 Ph: (503) 760-3214 | Andrew Sype Dmd, Pc 12758 Se Stark St Ste D Portland OR 97233-1539 Ph: (503) 760-3214 |
| NPI Number | 1114553468 |
|---|---|
| Provider Enumeration Date | 03/19/2020 |
| Last Update Date | 03/19/2020 |
| Medicare PECOS PAC ID | 9537557632 |
|---|---|
| Medicare Enrollment ID | O20211021002803 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114553468 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Andrew P Sype |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1306013800 PECOS PAC ID: 5092006148 Enrollment ID: I20211122002166 |
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