NPIMap

Organization Active NPI

DO, Ghorbanian, Im, Kwon

  • Dentist
  • Federal Way, WA
National Provider Identifier
1174883169
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00010309 Issued in WA
Legal business name
DO, GHORBANIAN, IM, KWON
Practice address
33600 6TH Ave So
Suite - 102
Federal Way, WA 98003
Phone
(253) 838-3232
Fax
(253) 838-6063
NPI assigned
May 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Authorized official

Name
Mrs. Chau Thi DO, DMD
Title
Dentist / Owner
Phone
(253) 838-3232

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DE00010309 WA Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DE00010883 WA
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X DE00009746 WA

Addresses

Primary practice location

33600 6TH Ave So
Suite - 102
Federal Way, WA 98003

Mailing address

33600 6TH Ave So
Suite - 102
Federal Way, WA 98003
Phone (253) 838-3232

Other names 1

  • Sunrise Dental of Federal Way Other name

National Provider Directory

National Provider Directory

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": "1337731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337731200000",
    "number": "1174883169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33600 6TH AVE SO",
            "address_2": "SUITE - 102",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "98003",
            "telephone_number": "253-838-3232",
            "fax_number": "253-838-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33600 6TH AVE SO",
            "address_2": "SUITE - 102",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "98003",
            "telephone_number": "253-838-3232",
            "fax_number": "253-838-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DO, GHORBANIAN, IM, KWON",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-23",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "CHAU",
        "authorized_official_middle_name": "THI",
        "authorized_official_title_or_position": "DENTIST / OWNER",
        "authorized_official_telephone_number": "253-838-3232",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010309",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010883",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE00009746",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Dental of Federal Way",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.