DR. KYLE EDWARD HERNDON (NPI# 1750883963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750883963 |
| Entity Type | Individual |
| Full Name | DR. KYLE EDWARD HERNDON |
| Other Name | DR. KYLE EDWARD HERNDON |
| Credential | DDS |
| Practice Address |
9225 Se Sunnyside Rd Ste 1 Clackamas OR 97015-6703 |
| Practice Telephone | 5039053380 |
| Mailing Telephone | 5039053380 |
| Enumeration Date | 2018-03-03 |
| Last Update Date | 2019-09-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D11057 | OR | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | CA | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4150 Clement St, San Francisco, CA 941211563 | 4157502046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699311621 | Kyle Andrew Herndon | Pharmacist | 5 Boone Vlg, Zionsville, IN 46077-1231 | 2019-11-25 |
| Street Address |
9225 SE SUNNYSIDE RD STE 1 |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-6703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366894453 | Karl S Shao | Dentist | 9225 Se Sunnyside Rd Ste 1, Clackamas, OR 97015-6703 | 2016-07-13 |
| 1962917724 | Cheryl Ann Drennan | Dental Hygienist | 9225 Se Sunnyside Rd Ste 1, Clackamas, OR 97015-6703 | 2017-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366894453 | Karl S Shao | Dentist | 9225 Se Sunnyside Rd Ste 1, Clackamas, OR 97015-6703 | 2016-07-13 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1699027672 | Clackamas Town Dental, LLC | Dentist | 9225 Se Sunnyside Road, Clackamas, OR 97086 | 2012-10-15 |
| 1285618470 | Dental Doc PC | Dentist | 11808 Se Sunnyside Rd, Clackamas, OR 97015-9308 | 2005-12-01 |
| 1205837135 | Ross Howard Hoevet | Dentist | 13520 Se 97th Ave, Clackamas, OR 97015-7691 | 2005-08-02 |
| 1376541433 | Quynh Diem Nguyen | Dentist | 12845 Se 93rd Ave, Clackamas, OR 97015 | 2005-07-12 |
| 1518564988 | Beatrix Zenger | Dentist | 15230 Se 82nd Dr, Clackamas, OR 97015-9606 | 2020-10-07 |
| 1447734132 | Andrew Chase Henderson | Dentist | 11808 Se Sunnyside Rd, Clackamas, OR 97015-9308 | 2018-09-19 |
| 1689025975 | Yizhou Zhu | Dentist | 13023 Se 84th Ave Ste A, Clackamas, OR 97015-9798 | 2016-06-28 |
| 1912301672 | Ryan Carpenter | Dentist | 15480 Se 82nd Dr, Clackamas, OR 97015-9633 | 2014-10-09 |
| Find all providers in CLACKAMAS | ||||
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| 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.