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JORDAN MYUNGDO WALLE
NPI 1780330282
Dentist - Dental Public Health in Klamath Falls, OR

Active since February 23, 2022PECOS Enrolled
2074 S 6TH ST, KLAMATH FALLS, OR 97601(541) 851-8110 Get Directions Write a Review

NPPES record last updated: July 30, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 30, 2024, Nov 15, 2023, Feb 23, 2022 (3 updates tracked since 2022).

About Jordan Myungdo Walle NPPES

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

JORDAN MYUNGDO WALLE (NPI 1780330282) is an individual dental public health provider in Klamath Falls, Oregon, licensed in Oregon (D11718) and active in the NPI registry since February 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780330282
Entity TypeIndividualMale
Primary Taxonomy1223D0001X
Provider Legal NameJORDAN MYUNGDO WALLE
Location Address2074 S 6TH STKlamath Falls, OR 97601-3372
Mailing Address2074 S 6th StKlamath Falls, OR 97601-3372 · (541) 851-8110
Phone(541) 851-8110
Sole ProprietorYes
Enumeration DateFebruary 23, 2022
Last NPPES UpdateJuly 30, 20243 updates tracked since enumeration
NPPES CertifiedJuly 30, 2024
✔ NPI 1780330282 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Dental Public HealthDental Providers
Taxonomy Code1223D0001X
License✔ Licensed in OR · D11718
Definition
The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2074 S 6TH ST, Klamath Falls, OR 97601
Open in Google Maps ↗

Other Identifiers 1

Medicaid500822026OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.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)

Jordan Myungdo Walle 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 97601 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
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.68 – $136.19
Typical copayment $17.16 (range $4.42 – $34.04)
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.

NOAH FUNK PA-C
Physician Assistant
2074 S 6TH ST
KLAMATH FALLS, OR 97601
Klamath County (541) 851-8110
DR. AARON MICHAEL DAVIS DMD
Dentist
2074 S 6TH ST
KLAMATH FALLS, OR 97601
Klamath County (541) 880-2090
LAURA COBIAN
Licensed Practical Nurse
2074 S 6TH ST
KLAMATH FALLS, OR 97601
Klamath County (541) 885-2011
JEFFRY PHILLIP KOLBUS DNP, APRN, AGPCNP-BC
Nurse Practitioner (Primary Care)
2074 S 6TH ST
KLAMATH FALLS, OR 97601
Klamath County (541) 851-8110
TIFFANY NICOLE FREGOSO RN
Registered Nurse
2074 S 6TH ST
KLAMATH FALLS, OR 97601
Klamath County (541) 851-8110
KYLIE RYANN COLLOM PHARMD
Pharmacist
2074 S 6TH ST
KLAMATH FALLS, OR 97601
Klamath County (541) 851-8110
MRS. CHRISTINE GUERRA QMHA I
Case Manager/Care Coordinator
2074 S 6TH ST
KLAMATH FALLS, OR 97601
Klamath County (541) 851-8110
DR. NICHOLAS A SMITH DMD
Dentist
2074 S 6TH ST
KLAMATH FALLS, OR 97601
Klamath County (541) 880-2090

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 Jordan Walle's NPI number?

The NPI number for Jordan Walle is 1780330282. It was assigned to this individual provider in the NPPES registry on February 23, 2022.

Where is Jordan Walle located?

Jordan Walle practices at 2074 S 6th St, Klamath Falls, OR 97601. The listed phone number is (541) 851-8110.

What is Jordan Walle's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Dental Public Health, with taxonomy code 1223D0001X.

Is Jordan Walle enrolled in Medicare?

Yes. Jordan Walle is registered in the Medicare PECOS enrollment system.

What insurance does Jordan Walle accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 10 other insurers list Jordan Walle as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jordan Walle was last updated on July 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.