NPIMap

Organization Active NPI

Dental Professionals of Washington Quirt Mongrain Gibree PC

Doing business as Colton Complete Dental Care

  • Dentist
  • Spokane, WA
National Provider Identifier
1174737274
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE7492 Issued in WA
Legal business name
DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC
Doing business as
Colton Complete Dental Care
Practice address
9302 N. Colton Street
Ste 202
Spokane, WA 99218
Phone
(509) 325-2188
Fax
(509) 326-2991
NPI assigned
May 9, 2007
Last updated
Feb 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

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

Authorized official

Name
Cassandra Petersen
Title
Credentialing Team Lead
Phone
(217) 540-8972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DE7492 WA Primary

Addresses

Primary practice location

9302 N. Colton Street
Ste 202
Spokane, WA 99218

Mailing address

9302 N. Colton Street
Ste 202
Spokane, WA 99218
Phone (509) 325-2188

Other names 1

  • Colton Complete Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Washington Quirt Mongrain Gibree PC29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

9302 N Colton St
Ste 202
Spokane, WA 99218
Phone (509) 325-2188

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518480000000",
    "number": "1174737274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9302 N. COLTON STREET",
            "address_2": "STE 202",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99218",
            "telephone_number": "509-325-2188",
            "fax_number": "509-326-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9302 N. COLTON STREET",
            "address_2": "STE 202",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99218",
            "telephone_number": "509-325-2188",
            "fax_number": "509-326-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2018-02-13",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "217-540-8972"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE7492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colton Complete Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.