Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mirror Pond Dental, LLC

Organization Dentist · NPI 1548719461

Mirror Pond Dental, LLC is a Dentist in Vancouver, Washington. Licensed in Washington. Registered with an NPI since 2016.

Licensed in
WA
In the registry since
2016
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1412 NE 134th St Ste 120
Vancouver, WA 98685
Phone: (360) 573-4848
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DE60682826 (WA)

Record details

NPI number1548719461
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marc Nordstrom — Member · (541) 610-7837
NPI enumeratedOctober 4, 2016
Last updated in NPPESOctober 4, 2016
Mailing address1475 Sw Chandler Ave Ste 201, Bend, OR 97702-3240

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