Individual provider Active NPI

Shoneen S Sendelback, D.M.D.

  • General Practice Dentistry
  • Forest Grove, OR
National Provider Identifier
1962486142
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D6976 Issued in OR
Practice address
1907 Mountain View LN
Suite 400
Forest Grove, OR 97116-2274
Phone
(503) 357-2158
Fax
(503) 357-0248
NPI assigned
Dec 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D6976 OR Primary

Addresses

Primary practice location

1907 Mountain View LN
Suite 400
Forest Grove, OR 97116-2274

Mailing address

1907 Mountain View LN
Suite 400
Forest Grove, OR 97116-2274
Phone (503) 357-2158

Other identifiers 1

IdentifierTypeStateIssuer
1638358OtherORUNITED CONCORDIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D6976ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Molly D. Saunders D.M.D. P.C. General Practice Past 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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1962486142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 MOUNTAIN VIEW LN",
            "address_2": "SUITE 400",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162274",
            "telephone_number": "503-357-2158",
            "fax_number": "503-357-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 MOUNTAIN VIEW LN",
            "address_2": "SUITE 400",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162274",
            "telephone_number": "503-357-2158",
            "fax_number": "503-357-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENDELBACK",
        "first_name": "SHONEEN",
        "middle_name": "S",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1638358",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Grove, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.