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 is a 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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