Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1770570251 Individual Practitioner Male Practitioner

Dr. Kyle H. Van , DDS

Dentist - General Practice • Beaverton, OR

Professional Overview & Biography Verified Profile Summary

Dr. Kyle Van, DDS is a registered healthcare professional specializing in Dentist - General Practice in Beaverton, OR. Practice services are available at 16755 SW BASELINE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

16755 Sw Baseline Rd

Beaverton, OR 970064241

Telephone 5035334001
Fax 5035334116
Associated Practice Facility / Clinic
🏢 Perledent Dental Care, Pc Facility NPI 1255704813

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Beaverton, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
91 Specialists

Practicing in Beaverton, OR (1994 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License OR D7871

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Frederick Ganji , DDS

Dentist - General Practice

NPI 1720197429

Doctor of Dental Surgery

Tanya Kornuta , RDH

Dental Hygienist

NPI 1720469240

Registered Dental Hygienist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 16755 SW BASELINE RD, BEAVERTON, OR 970064241 (Tel: 5035334001)

📍
Updated Business Mailing Address July 08, 2007

Registered at 420 NW 11TH AVE, PORTLAND, OR 972092972 (Tel: 5037023565)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as KYLE VAN, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #D7871 in OR)

🟢
Initial NPI Registration & Enumeration September 30, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Kyle Van. Be the first to share your experience!

Sign in to leave a review for Dr. Kyle Van

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1770570251
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 30, 2005
Last Update: July 13, 2026
Sole Proprietor: No

Mailing Address

420 Nw 11th Ave

Portland, OR 972092972

Phone: 5037023565

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.