MC-NSPK LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8440 Issued in WA

Legal business name

MC-NSPK LLC

Doing business as

Mint Condition Dental

Practice address

5901 N. Lidgerwood
Ste 233
Spokane, WA 99208

Phone

(509) 489-4763

Fax

(509) 489-4767

NPI assigned

Jun 7, 2006

Last updated

Jun 28, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Marshall F Gibbs, DDS

Title

Owner

Phone

(509) 235-2900

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Mint Condition Dental Doing business as

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1164462487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19187",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992199187",
            "telephone_number": "509-489-4763",
            "fax_number": "509-489-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 N. LIDGERWOOD",
            "address_2": "STE 233",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99208",
            "telephone_number": "509-489-4763",
            "fax_number": "509-489-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MC-NSPK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-235-2900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "60240234",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "8853",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "8440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5031968",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mint Condition Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donald Tsvaganayi Mazhou
• Clare Ime Mbang
• Sasha Elise Mbolekwa, CPC
• Joyce Wambui Mbugua
• Jackson Mbuthia
• Melanie M McAdams, MSW
• Sheenna Lee McAdoo, SUDPT
• Chris Daniel McAfee
• Caressa McAllister
• Elizabeth J McAndrews, MSW

• General Practice Dentistry in Spokane, WA
• Providers in Spokane, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.