DR. KYLE EDWARD HERNDON DDS
NPI 1750883963
Dentist in Beaverton, OR

Q: What is Kyle Herndon's NPI number?

The NPI number for Kyle Herndon is 1750883963. It was assigned to this individual provider in the NPPES registry on March 3, 2018. The provider is also known as Dr. Kyle Edward Herndon.

Q: What is Kyle Herndon's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kyle Herndon was last updated on December 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since March 03, 2018PECOS Enrolled

4925 SW GRIFFITH DR, BEAVERTON, OR 97005(855) 433-6825 Get Directions Write a Review

NPPES record last updated: December 9, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 9, 2021, Sep 5, 2019, Mar 3, 2018 (3 updates tracked since 2018).

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About Dr. Kyle Edward Herndon Dds NPPES

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

DR. KYLE EDWARD HERNDON DDS (NPI 1750883963) is an individual dentist in Beaverton, Oregon, licensed in Oregon (D11057) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750883963

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. KYLE EDWARD HERNDONCredential: DDS

Location Address4925 SW GRIFFITH DRBeaverton, OR 97005-2923

Mailing Address6950 Ne Campus WayHillsboro, OR 97124-5611 · (855) 433-6825

Phone(855) 433-6825

Sole ProprietorYes

Enumeration DateMarch 3, 2018

Last NPPES UpdateDecember 9, 20213 updates tracked since enumeration

NPPES CertifiedDecember 9, 2021

✔ NPI 1750883963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in OR · D11057

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

4925 SW GRIFFITH DR, Beaverton, OR 97005

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Other Names 1

Former Name (1)Dr. Kyle Edward Herndon

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kyle Edward Herndon Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97005 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.51 typical visit price

range $58.99 – $176.88

Typical copayment $22.62 (range $14.74 – $44.22)

Most-billed visit code 99203

Established Patient

$73.28 typical visit price

range $19.32 – $144.79

Typical copayment $18.32 (range $4.83 – $36.19)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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