- Practice location
- 11820 SW King James Pl, J10, Tigard, OR 97224-2480
- Phone
- 503-616-5000
- Fax
- —
- Last updated
- June 11, 2020
Stacy Eden is a Dentist based in Tigard, OR. Stacy Eden practices in Tigard, OR and has the professional credentials of DDS. The NPI Number for Stacy Eden is 1114248085 and holds a License No. D10481 (OR). The current practice location address for Stacy Eden is 11820 SW King James Pl, J10, Tigard, OR 97224-2480 and can be reached out via phone at 503-616-5000.
Provider Profile Details
- NPI Number
- 1114248085
- Provider Name
- Stacy Eden
- Credential
- DDS
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 11820 SW King James Pl, J10, Tigard, OR 97224-2480
- Phone Number
- 503-616-5000
- Primary Taxonomy
- Dentist · 122300000X
- Sole Proprietor
- No
- Provider Enumeration Date
- June 15, 2010
- Last Update Date
- June 11, 2020
- Certification Date
- June 11, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 11820 SW King James Pl
J10
Tigard, OR 97224-2480 - City
- Tigard
- State
- Oregon
- Zip
- 97224-2480
- Phone Number
- 503-616-5000
Provider Business Mailing Address Details
- Address
- 11820 SW King James Pl
J10
Tigard, OR 97224-2480 - City
- Tigard
- State
- OR
- Zip
- 97224-2480
- Phone Number
- 503-616-5000
License Information
- License Number
- D10481
- License State
- OR
- Taxonomy
- Dentist · 122300000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Dentists near Tigard, OR
View all Dentists in Tigard →Frequently Asked Questions
What is the NPI number of Stacy Eden, DDS?
The NPI number of Stacy Eden, DDS is 1114248085. It was assigned on June 15, 2010 and is currently active in the NPPES registry.
What is the specialty of Stacy Eden, DDS?
Stacy Eden, DDS is registered under the primary taxonomy Dentist (code 122300000X), licensed in OR under license number D10481.
Where does Stacy Eden, DDS practice?
The practice location is 11820 SW King James Pl, J10, Tigard, OR 97224-2480. The office can be reached at 503-616-5000 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1114248085 directly on the NPPES registry website.