Individual provider Active NPI

Kaylin Lorbert

  • Pediatric Dentistry
  • Salem, OR
National Provider Identifier
1336696160
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D12283 Issued in OR
Practice address
799 Lancaster Dr NE Ste 140
Salem, OR 97301-5235
Phone
(503) 400-6674
NPI assigned
Sep 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN.00203136 CO
Pediatric Dentistry 1223P0221X 0401418856 VA
Pediatric Dentistry 1223P0221X D12283 OR Primary

Addresses

Primary practice location

799 Lancaster Dr NE Ste 140
Salem, OR 97301-5235

Mailing address

6209 Mackenzie Valley CT
Saint Louis, MO 63123-3476

Other identifiers 2

IdentifierTypeStateIssuer
1336696160MedicaidCO
DEN.00203136OtherCOCO DENTAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220727002834 MO Order and Referring Only - DentistPractitioner - Dentist 9638551336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00203136COMDDentist
D12283ORMDPediatric Dentist
0401418856VAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Acorn Dentistry for Kids - Orthodontics PastSince Mar 12, 2023 Accepting new patients

Organizations & group practices 1

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": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1336696160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6209 MACKENZIE VALLEY CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631233476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 LANCASTER DR NE STE 140",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015235",
            "telephone_number": "503-400-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORBERT",
        "first_name": "KAYLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00203136",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401418856",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D12283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336696160",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO DENTAL LICENSE",
            "identifier": "DEN.00203136",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.