MIRROR POND DENTAL, LLC
NPI 1548719461
Dentist in Vancouver, WA

Q: What is Mirror Pond Dental, LLC's NPI number?

The NPI number for Mirror Pond Dental, LLC is 1548719461. It was assigned to this organization in the NPPES registry on October 4, 2016.

Q: What is Mirror Pond Dental, LLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since October 04, 2016

1412 NE 134TH ST. SUITE 120, VANCOUVER, WA 98685(360) 573-4848 Get Directions Write a Review

NPPES record last updated: October 4, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mirror Pond Dental, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIRROR POND DENTAL, LLC (NPI 1548719461) is a healthcare organization registered as a dentist in Vancouver, Washington and active in the NPI registry since October 2016. The organization lists Marc Andrew Nordstrom, Member, as its authorized official.

NPPES Registry Identity

NPI1548719461

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameMIRROR POND DENTAL, LLC

Location Address1412 NE 134TH ST. SUITE 120Vancouver, WA 98685

Mailing Address1475 Sw Chandler Ave Ste 201Bend, OR 97702-3240 · (541) 610-7837

Phone(360) 573-4848

Organization SubpartNo

Authorized OfficialMarc Andrew NordstromMember · (541) 610-7837

Enumeration DateOctober 4, 2016

✔ NPI 1548719461 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in WA · DE60682826

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.

1412 NE 134TH ST. SUITE 120, Vancouver, WA 98685

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mirror Pond Dental, LLC's NPI number?

The NPI number for Mirror Pond Dental, LLC is 1548719461. It was assigned to this organization in the NPPES registry on October 4, 2016.

Where is Mirror Pond Dental, LLC located?

Mirror Pond Dental, LLC is located at 1412 NE 134th St. Suite 120, Vancouver, WA 98685. The listed phone number is (360) 573-4848.

What is Mirror Pond Dental, LLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Mirror Pond Dental, LLC was last updated on October 4, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.