Individual
DR. VIDYA MADHURI KOPPINEEDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
7836 NE SANDY BLVD, PORTLAND, OR 97213-6467
(503) 288-3107
Mailing address
7844 SW ALDER ST, TIGARD, OR 97224-7240
(503) 432-0919
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8689
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240161
OMAP ID NUMBER
OR
Enumeration date
02/26/2007
Last updated
07/08/2007
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