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Dr. Audrey Michelle Mikkelson, DMD,MSD
Pediatric Dentist in Salem, Oregon
NPI 1912394578

Audrey Michelle Mikkelson is a Pediatric Dentist based in Wilsonville, OR and is specialized in Pediatric Dentistry. Audrey Michelle Mikkelson practices in Salem, OR and has the professional credentials of DMD,MSD. The NPI Number for Audrey Michelle Mikkelson is 1912394578 and holds a License No. D10484 (Oregon).

The current practice location address for Audrey Michelle Mikkelson is 3745 Portland Rd Ne Ste 190, Salem, OR and can be reached out via phone at 971-232-5858. You can also correspond with Audrey Michelle Mikkelson through the mailing address at 28236 SW WAGNER ST, WILSONVILLE, OR - 97070-6784 (mailing address contact number: 503-975-5001).

Location: 3745 Portland Rd Ne Ste 190, Salem, OR, 97070-6784
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912394578
Provider Name
Audrey Michelle Mikkelson
Credential
DMD,MSD
Provider Entity Type
Individual
Gender
Female
Address
3745 Portland Rd Ne Ste 190, Salem, OR, 97070-6784
Phone Number
971-232-5858
Fax Number
Provider Enumeration Date
04/22/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3745 Portland Rd Ne Ste 190
City
Salem
State
Oregon
Zip
97301-0529
Phone Number
971-232-5858
Fax Number
person
Provider Business Mailing Address Details
Address
28236 Sw Wagner St
City
Wilsonville
State
Oregon
Zip
97070-6784
Phone Number
503-975-5001
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
D10484 (Oregon)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
D10484 (Oregon)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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