NPIMap

Organization Active NPI

Ledental LLC

Doing business as Chinook Falls Dental

  • General Practice Dentistry
  • Sandy, OR
National Provider Identifier
1104360718
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D9841 Issued in OR
Legal business name
LEDENTAL LLC
Doing business as
Chinook Falls Dental
Practice address
36840 Industrial Way
Sandy, OR 97055-9254
Phone
(503) 668-8301
NPI assigned
Dec 16, 2016
Last updated
Dec 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Tin Minh Le, DMDNPI 1922299445
Title
Owner
Phone
(503) 544-4889

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D9841 OR Primary

Addresses

Primary practice location

36840 Industrial Way
Sandy, OR 97055-9254

Mailing address

36840 Industrial Way
Sandy, OR 97055-9254
Phone (503) 668-8301

Other names 1

  • Chinook Falls Dental Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240220004492 OR Part B Supplier - Clinic/Group Practice 8022452838 Receives reassigned benefits from 1 practitioner
Practice locations: Sandy, OR

National Provider Directory

National Provider Directory

Locations

36840 Industrial Way
Ste A
Sandy, OR 97055
Phone (503) 668-8301

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481846400000",
    "number": "1104360718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36840 INDUSTRIAL WAY",
            "city": "SANDY",
            "state": "OR",
            "postal_code": "970559254",
            "telephone_number": "503-668-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36840 INDUSTRIAL WAY",
            "city": "SANDY",
            "state": "OR",
            "postal_code": "970559254",
            "telephone_number": "503-668-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEDENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-16",
        "last_updated": "2016-12-16",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "TIN",
        "authorized_official_middle_name": "MINH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-544-4889",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chinook Falls Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandy, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.