Individual provider Active NPI

Nathan D Lenox, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Bend, OR
National Provider Identifier
1245440676
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D10398 Issued in OR
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

Updated by the provider on Nov 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
07904MedicaidLA

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
Green means eligible to order or refer.
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

LicenseStateTypeSpecialty
D10398ORMDOral and Maxillofacial Surgery (Dentist)
S-476LAMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
K & L Oms LLC Oral and Maxillofacial Surgery PastSince Jul 24, 2022 Accepting new patients
K & L Oms LLC PastSince Jan 1, 2023 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.

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

Verify at the official NPI Registry.