Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1851068506 Individual Practitioner Female Practitioner

Dr. Jennifer Ta Ly , DMD

Dentist - General Practice • Vancouver, WA

Professional Overview & Biography Verified Profile Summary

Dr. Jennifer Ly, DMD is a registered healthcare professional specializing in Dentist - General Practice in Vancouver, WA. Practice services are available at 14201 NE 20TH AVE STE A101 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

14201 Ne 20th Ave Ste A101

Vancouver, WA 986866411

Telephone 3608820222
Associated Practice Facility / Clinic
🏢 Td Salmon Creek Llp Facility NPI 1811760200

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Vancouver, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.3 Yrs
Regional Practice Density
158 Specialists

Practicing in Vancouver, WA (3345 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

CMS Verified: 2025-10-24
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License WA DE61309953

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.

Dentist

NUCC Taxonomy Code: 122300000X

State License WA DE61309953

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.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License OR D11518

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
2309037 (WA)

Secondary Practice Locations

19005 Se 34th St

Vancouver, WA 986831450

Phone: 3607266730

Practice Associates & Co-Workers

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

6 Associated Practitioners
Dr. Alvin Watanabe , DMD

Dentist - General Practice

NPI 1285675652

Doctor of Dental Medicine

Dr. Brian Bardeloza , DDS

Dentist - General Practice

NPI 1477076727

Doctor of Dental Surgery

Deanna Reijonen , RDH

Dental Hygienist

NPI 1659480473

Registered Dental Hygienist

NPI 1801382387

Doctor of Dental Surgery

Dr. Dany Tse , DMD

Dentist - General Practice

NPI 1861421471

Doctor of Dental Medicine

Dr. Scott Mcclure , DDS

Dentist - General Practice

NPI 1902842032

Doctor of Dental Surgery

Career & Practice History Timeline

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

12 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 24, 2025

Dentist (License #DE61309953 in WA)

📍
Updated Business Mailing Address March 27, 2025

Registered at PO BOX 34703, SEATTLE, WA 981241703

👤
Provider Name / Credentials Updated December 10, 2023

Recorded as JENNIFER LY, DMD

📍
Updated Practice Location October 04, 2022

Registered at 14201 NE 20TH AVE STE A101, VANCOUVER, WA 986866411 (Tel: 3608820222)

📍
Updated Business Mailing Address October 04, 2022

Registered at 8405 NE 168TH AVE, VANCOUVER, WA 986821315 (Tel: 3609184698)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 06, 2022

Dentist (License #DE61309953 in WA)

NPI Profile Active August 29, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location August 29, 2021

Registered at 645 9TH ST NW STE 110, SALEM, OR 973043299 (Tel: 9719005599)

📍
Updated Business Mailing Address August 29, 2021

Registered at 4498 NORTHSIDE DR NE, KEIZER, OR 973032284 (Tel: 3609184698)

👤
Provider Name / Credentials Updated August 29, 2021

Recorded as JENNIFER TA, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 29, 2021

Dentist (License #D11518 in OR)

🟢
Initial NPI Registration & Enumeration August 29, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1851068506
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 29, 2021
Last Update: October 24, 2025
Sole Proprietor: No

Mailing Address

Po Box 34703

Seattle, WA 981241703

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.