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Mirror Pond Dental, LLC

NPI 1225401052ActiveOrganization· Dentist, General Practice· Bend, OR

Dentist, General Practice in Bend, Oregon, registered in NPPES in November 2015. The authorized official on file is Marc Nordstrom, DMD, Owner.

Overview

NPI1225401052
StatusActive
Entity typeOrganization
NPI issuedNov 2, 2015
Last updated in NPPESNov 2, 2015

Specialties and licenses

TaxonomyCodeLicenseState
Dentist, General Practice Primary1223G0001XD7335OR

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

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