KYLIE WASSERMAN (NPI# 1417484296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417484296 |
| Entity Type | Individual |
| Full Name | KYLIE WASSERMAN |
| Credential | D.D.S. |
| Practice Address |
965 Sw Emkay Dr Ste 100 Bend OR 97702 |
| Mailing Address |
965 Sw Emkay Dr Ste 100 Bend OR 97702-3598 |
| Practice Telephone | 5413830754 |
| Mailing Telephone | 5413830754 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2018-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D10789 | OR | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
D10789 | OR | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | DENTIST, HEALTH CARE | 1417484296 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3181 Sw Sam Jackson Park Rd, Portland, OR 972393011 | 5034948211 |
| Street Address |
965 SW EMKAY DR STE 100 |
| City | BEND |
| State | OR |
| Zip Code | 97702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676259 | Amy Michelle Anderson | Counselor | 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 | 2020-10-15 |
| 1386259463 | Jacob Rehder | Counselor | 19717 Mt Batchelor Dr, #226, Bend, OR 97702 | 2020-09-15 |
| 1497385215 | Capacity Performance Therapy | Physical Medicine & Rehabilitation | 61125 Lodgepole Dr., Bend, OR 97702 | 2020-01-21 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1609435049 | Praxis Medical Group Inc | Orthopaedic Surgery | 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 | 2019-06-10 |
| 1013485754 | Elana Leah Pesah | Social Worker | 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 | 2018-11-12 |
| 1104303239 | Kyleigh Mcvey | Massage Therapist | 999 Sw Disk Dr, Bend, OR 97702 | 2018-07-21 |
| 1477042869 | Siloe Castaneda Huerta | Counselor | 1340 Nw Wall, Bend, Or, Bend, OR 97702 | 2018-05-02 |
| 1164910808 | Rebecca M Joyce | Social Worker | 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 | 2018-04-27 |
| 1093217978 | Jennifer Bury | Acupuncturist | 296 Sw Columbia St Ste D1, Bend, OR 97702 | 2018-03-06 |
| Find all providers in zip 97702 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316580715 | Affordable Dentures & Implants - Bend, P.C. | Dentist | 63455 N Highway 97 Ste 13, Bend, OR 97703-5724 | 2019-10-18 |
| 1528545514 | Kellie Michiko Kawasaki-jones | Dentist | 62968 Ob Riley Road, Suite 12, Bend, OR 97701 | 2018-07-23 |
| 1760992382 | Jared R. Anderson, Dds, PC | Dentist | 499 Sw Upper Terrace Dr. #b, Bend, OR 97702 | 2017-10-10 |
| 1578949541 | Colin Alfred Dole | Dentist | 1201 Nw Wall St, Bend, OR 97701-1956 | 2015-07-31 |
| 1588043277 | Veronica Catherine Matthews | Dentist | 20516 Robal Road, Bend, OR 97701 | 2015-05-27 |
| 1245654789 | Michael J Longlet | Dentist | 775 Sw Bonnett Way Ste 100, Bend, OR 97702 | 2014-02-04 |
| 1669894994 | Thomas M Spoonster | Dentist | 1239 Ne Medical Center Dr Ste 220, Bend, OR 97701-7359 | 2014-01-06 |
| 1457787244 | Brolen Freimanis | Dentist | 3081 Business 97 Ste 150, Bend, OR 97701 | 2013-09-24 |
| 1295099109 | Hallie Lee Mcnaughton | Dentist | 2551 Nw 1st St, Bend, OR 97701-1200 | 2012-06-26 |
| 1518246578 | Cody Simon Negrete | Dentist | 62968 O B Riley Rd Bldg D, Bend, OR 97703-9442 | 2011-08-09 |
| Find all providers in BEND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.