Individual provider Active NPI

Jeffrey Powers Langdon, DMD

  • Dentist
  • Longview, WA
National Provider Identifier
1396398673
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE61215194 Issued in WA
Practice address
1105 14TH Ave
Longview, WA 98632-3016
Phone
(360) 207-2501
NPI assigned
Jul 16, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D11264 OR
Dentist 122300000X 9454 SC
General Practice Dentistry 1223G0001X D11264 OR
Dentist 122300000X DE61215194 WA Primary

Addresses

Primary practice location

1105 14TH Ave
Longview, WA 98632-3016

Mailing address

3218 Ammons Dr
Longview, WA 98632-5371
Phone (650) 776-0840

Other practice location 1

1123 Ashley River Rd
Charleston, SC 29407-7101
Phone (843) 410-6266

Other practice location 2

303 E A St
Rainier, OR 97048-3132
Phone (971) 251-6154

Other practice location 3

5711 Rivers Ave
North Charleston, SC 29406-6028
Phone (843) 593-0403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20210825001962 OR Order and Referring Only - DentistPractitioner - Dentist 3274938584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE61215194WAMDDentist
9454SCMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1396398673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3218 AMMONS DR",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986325371",
            "telephone_number": "650-776-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 14TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323016",
            "telephone_number": "360-207-2501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1123 Ashley River Rd",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294077101",
            "country_code": "US",
            "telephone_number": "843-410-6266",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "303 E A St",
            "address_purpose": "LOCATION",
            "city": "Rainier",
            "state": "OR",
            "postal_code": "970483132",
            "country_code": "US",
            "telephone_number": "971-251-6154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5711 Rivers Ave",
            "address_purpose": "LOCATION",
            "city": "North Charleston",
            "state": "SC",
            "postal_code": "294066028",
            "country_code": "US",
            "telephone_number": "843-593-0403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANGDON",
        "first_name": "JEFFREY",
        "middle_name": "POWERS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11264",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "9454",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11264",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61215194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.