Active NPI
Jeffrey Powers Langdon, DMD
- Dentist
- Longview, WA
National Provider Identifier
1396398673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE61215194
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210825001962 | OR | Order and Referring Only - Dentist | 3274938584 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE61215194 | WA | MD | Dentist |
| 9454 | SC | MD | Massage 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.