Individual
DR. LANDIS KWONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
13255 SE STARK ST, PORTLAND, OR 97233-1548
(855) 433-6825
Mailing address
6950 NE CAMPUS WAY, HILLSBORO, OR 97124-5611
(855) 433-6825
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11358
OR
1223G0001X
General Practice Dentistry
DE61172259
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2172382
—
WA
Enumeration date
04/01/2020
Last updated
04/02/2024
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