MIRROR POND DENTAL, LLC


Address: 1412 Ne 134th St. Suite 120, Vancouver, WA 98685
Phone: 3605734848

MIRROR POND DENTAL, LLC (NPI# 1548719461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548719461
Entity Type Organization
Organization Name MIRROR POND DENTAL, LLC
Practice Address 1412 Ne 134th St. Suite 120
Vancouver
WA 98685
Mailing Address 1475 Sw Chandler Ave Ste 201
Bend
OR 97702-3240
Practice Telephone 3605734848
Mailing Telephone 5416107837
Enumeration Date 2016-10-04
Last Update Date 2016-10-04
Authorized Official Name MARC ANDREW NORDSTROM (MEMBER)
Authorized Official Telephone 5416107837
Authorized Official Credential DMD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 122300000X Dentist DE60682826 WA Dental Providers

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1225401052 Mirror Pond Dental, LLC Dentist 102 Nw Newport Ave, Bend, OR 97703-1838 2015-11-02

Other Data Sources

Entity Type Entity Name Entity Address
Oregon Corporations, Companies and Business Names MIRROR POND DENTAL, LLC 108 Nw Newport Ave, Bend, OR 97703

Office Location

Street Address 1412 NE 134TH ST. SUITE 120
City VANCOUVER
State WA
Zip Code 98685

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225650112 Zachary Dodds Massage Therapist 12314 Nw 42nd Ct, Vancouver, WA 98685 2020-05-13
1760996425 Eric Moore Physical Therapy Assistant 1308 Ne 134th Street, Suite 110, Vancouver, WA 98685 2017-11-16
1942711767 Julie B Lawrence Nurse Practitioner 900 Ne 139th Street, Suite 202, Vancouver, WA 98685 2017-10-19
1538688668 Carrie Roxann Wolfe Counselor 1313 Ne 134th St Ste 220a, Vancouver, WA 98685 2017-09-09
1629522958 Deanna Carter Massage Therapist 1319 Ne 134th Street, Vancouver, WA 98685 2016-08-03
1417329020 Kaleen Hoyt Massage Therapist 1319 Nw 134th St Suit 103, Vancuver, WA 98685 2015-10-22
1497173066 Kelley Heffelfinger Behavioral Analyst 9901 Ne 7th Ave., Suite C-116, Vancouver, WA 98685 2014-04-01
1548512791 Elana S Kier Social Worker 10000 Ne 7th Ave Ste 100b, Vancouver, WA 98685 2012-10-12
1922370469 Brian R Timms Chiropractor 1412 Ne 134th St Ste 100, Vancouver, WA 98685 2012-01-30
1336436906 Justin Anthony Heaton Dentist 900 Ne 139th St Ste 106, Vancouver, WA 98685 2011-07-05
Find all providers in zip 98685

Taxonomy Information

Taxonomy Code 122300000X
Grouping Dental Providers
Classification Dentist

Taxonomy Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1639787088 Andrey Vorobets Dentist 12403 Ne 20th St, Vancouver, WA 98684-5566 2020-07-21
1689207318 Beatriz Ellen Fortanely Dentist Ubc Faculty of Dentistry, 2151 Wesbrook Mall, Vancouver, BC V6T 1Z3 2020-02-21
1891258711 Washington Dental Corporation, PC Dentist 14411 Ne Fourth Plain, Suite 134, Vancouver, WA 98682 2019-04-08
1356819403 Kesang Yangchen Norbhu Dentist 7202 Ne Highway 99 Ste 100, Vancouver, WA 98665-8932 2018-11-07
1326514803 Haseeb Hussain Dentist 8400 Ne Vancouver Mall Loop Ste 105, Vancouver, WA 98662-6672 2018-10-22
1023584877 Always Smiles Dentistry Dentist 910 Ne Minnehaha St #12, Vancouver, WA 98665 2018-10-19
1730664772 Thomas Shogo Backus Dentist 503 Nw 84th Cir, Vancouver, WA 98665-7720 2018-09-25
1801382387 Kristopher K Kostenko Dentist 14201 Ne 20th Ave Ste A101, Vancouver, WA 98686 2018-07-08
1831699198 Isabel Ane Sobrado Dentist 12425 Ne 20th St, Vancouver, WA 98684-5566 2018-02-13
1689197808 Shawn P Platt Dentist 1300 Esther St Ste 101, Vancouver, WA 98660-2890 2017-07-19
Find all providers in VANCOUVER

Competitor

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City VANCOUVER
Zip Code 98685

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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