NPI 1558110668 · live from the CMS NPI Registry
Brenna Kathryn Amundson
Dentist in Apo, AP. National Provider Identifier 1558110668, active.
NPI record
| NPI | 1558110668 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist 122300000X |
| Practice location | 18th Medical Group, Unit 5268, Apo, AP 96368 |
| Practice phone | 315-630-4817 |
| Mailing address | 1075 Nw 16th Ave Apt 501, Portland, OR 97209 |
| Enumerated | May 13, 2024 |
| Last updated | July 31, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist primary | 122300000X | D12041 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.