Provider Demographics
NPI:1902898299
Name:LITTLE, STEVEN JAMES (DMD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:LITTLE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 SW SCHOLLS FERRY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1959
Mailing Address - Country:US
Mailing Address - Phone:503-292-6677
Mailing Address - Fax:503-292-1323
Practice Address - Street 1:4455 SW SCHOLLS FERRY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-1959
Practice Address - Country:US
Practice Address - Phone:503-292-6677
Practice Address - Fax:503-292-1323
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR68871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice