Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Audrey Michelle Mikkelson, DMD, MSD

Individual provider Pediatric Dentistry · NPI 1912394578

Dr. Audrey Michelle Mikkelson, DMD, MSD practises Pediatric Dentistry in Portland, Oregon. Licensed in Oregon and Washington. Registered with an NPI since 2015.

Licensed in
OR, WA
In the registry since
2015
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

5415 SW Westgate Dr Ste 207
Portland, OR 97221-2429
Phone: (503) 292-9274
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence D10484 (OR)
Pediatric Dentistry Taxonomy 1223P0221X · Licence DE61168847 (WA)

Record details

NPI number1912394578
Entity typeIndividual (Type 1)
GenderFemale
Credentials DMD , MSD
Sole proprietorNo
NPI enumeratedApril 22, 2015
Last updated in NPPESNovember 5, 2024
Certification dateNovember 5, 2024

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