OrganizationActive
Mirror Pond Dental, LLC
NPI 1225401052 · General Practice Dentistry · Bend, OR
Provider details
- NPI number
- 1225401052
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Marc Nordstrom, Owner(541) 382-2256
- License
- D7335 (OR)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
102 Nw Newport Ave
Bend, OR 97703-1838
Phone: (541) 382-2256
Fax: (541) 389-5229
Street-level locationGet directions
Mailing address
102 Nw Newport Ave
Bend, OR 97703-1838
Registry dates
- Enumerated
- 2015-11-02
- Last updated
- 2015-11-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.