NPIMap

Organization Active NPI

Nurani, Mitchell, Kim, PC

  • Dentist
  • Olympia, WA
National Provider Identifier
1154766228
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00008078 Issued in WA
Legal business name
NURANI, MITCHELL, KIM, PC
Practice address
1530 Black Lake Blvd SW Ste A103
Olympia, WA 98502-5612
Phone
(360) 338-7152
Fax
(360) 943-0152
NPI assigned
May 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ashifa A Nurani, DDS
Title
President
Phone
(714) 578-6358

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DE00008078 WA Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X

Addresses

Primary practice location

1530 Black Lake Blvd SW Ste A103
Olympia, WA 98502-5612

Mailing address

1530 Black Lake Blvd SW Ste A103
Olympia, WA 98502-5612
Phone (360) 338-7152

Other names 1

  • BRIGHT NOW DENTAL OLYMPIA BLACK LAKE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fratt Dental Corporation132 organizations share this tax ID, including this one

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449446400000",
    "number": "1154766228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 BLACK LAKE BLVD SW STE A103",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025612",
            "telephone_number": "360-338-7152",
            "fax_number": "360-943-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 BLACK LAKE BLVD SW STE A103",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025612",
            "telephone_number": "360-338-7152",
            "fax_number": "360-943-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURANI, MITCHELL, KIM, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-02",
        "last_updated": "2015-12-07",
        "status": "A",
        "authorized_official_last_name": "NURANI",
        "authorized_official_first_name": "ASHIFA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-578-6358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00008078",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRIGHT NOW DENTAL OLYMPIA BLACK LAKE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.