Active NPI
Nathan D Lenox, DMD, MD
- Oral and Maxillofacial Surgery (Dentist)
- Bend, OR
National Provider Identifier
1245440676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- D10398
- Practice address
- 1475 SW Chandler Ave
Suite 101
Bend, OR 97702 - Phone
- (541) 317-6993
- Fax
- (541) 617-0030
- NPI assigned
- May 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | S-476 | LA | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | D10398 | OR | Primary |
Addresses
Primary practice location
1475 SW Chandler Ave
Suite 101
Bend, OR 97702
Mailing address
1475 SW Chandler Ave
Suite 101
Bend, OR 97702
Phone (541) 317-6993
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07904 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 20, 2016 through Apr 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D10398 | OR | MD | Oral and Maxillofacial Surgery (Dentist) |
| S-476 | LA | MD | Oral & Maxillofacial Surgery (D.M.D.) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K & L Oms LLC | Oral and Maxillofacial Surgery | Past | Accepting new patients |
| K & L Oms LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Oral and Maxillofacial Surgery Clinic/Center
- Bend, OR
- NPI 1063942043
-
- Oral and Maxillofacial Surgery Clinic/Center
- Redmond, OR
- NPI 1598478109
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541635200000",
"number": "1245440676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1475 SW CHANDLER AVE",
"address_2": "SUITE 101",
"city": "BEND",
"state": "OR",
"postal_code": "97702",
"telephone_number": "541-317-6993",
"fax_number": "541-617-0030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1475 SW CHANDLER AVE",
"address_2": "SUITE 101",
"city": "BEND",
"state": "OR",
"postal_code": "97702",
"telephone_number": "541-317-6993",
"fax_number": "541-617-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LENOX",
"first_name": "NATHAN",
"middle_name": "D",
"credential": "DMD, MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2018-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "LA",
"license": "S-476",
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "OR",
"license": "D10398",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07904",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.