Provider Demographics
NPI:1386520492
Name:FAKIH, HUSSEIN H
Entity type:Individual
Prefix:
First Name:HUSSEIN
Middle Name:H
Last Name:FAKIH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10705 SW 71ST AVE
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8702
Mailing Address - Country:US
Mailing Address - Phone:503-860-1314
Mailing Address - Fax:
Practice Address - Street 1:10705 SW 71ST AVE
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8702
Practice Address - Country:US
Practice Address - Phone:503-860-1314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD12209122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist