Brendon Shibley

NPI 1124833363 · on the registry since 2025

Practice

Address: 4823 Meadows Rd Ste 127
Lake Oswego, OR 97035
Phone: (888) 227-3312
Organisation at this address: Lake Oswego Modern Dentistry, Pc
Providence Health & Services Oregon
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 4

Registry record

Primary taxonomy: 363LF0000X
363LF0000X
Also registered as: 363LF0000X
Licence states on file: WA, AZ
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2026-08-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon