Provider Demographics
NPI:1174796619
Name:PAXTON, DAIN CAMERON I (DMD)
Entity type:Individual
Prefix:DR
First Name:DAIN
Middle Name:CAMERON
Last Name:PAXTON
Suffix:I
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 1:620 SW 5TH AVE
Mailing Address - Street 2:SUITE 1006
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-1428
Mailing Address - Country:US
Mailing Address - Phone:503-228-1470
Mailing Address - Fax:503-228-4907
Practice Address - Street 1:620 SW 5TH AVE STE 1006
Practice Address - Street 2:SUITE 1006
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-1424
Practice Address - Country:US
Practice Address - Phone:503-228-1470
Practice Address - Fax:503-228-4907
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53394122300000X
OR7397122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist