Derek Zhao, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE.61157736 Issued in WA

Practice address

14411 Ambaum Blvd SW
Burien, WA 98166-1423

Phone

(206) 246-4559

NPI assigned

Jun 7, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dzhao857203@direct.multicare.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Justin Vanbibber DDS PC

  • Dentist
  • Burien, WA
  • NPI 1689029688

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1184283715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13404 NEWCASTLE COMMONS DR APT 329",
            "city": "NEWCASTLE",
            "state": "WA",
            "postal_code": "980593212",
            "telephone_number": "206-913-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14411 AMBAUM BLVD SW",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661423",
            "telephone_number": "206-246-4559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9650 15th Ave SW Ste 100",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981062576",
            "country_code": "US",
            "telephone_number": "206-965-1005",
            "fax_number": "206-965-1042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHAO",
        "first_name": "DEREK",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-07",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE.61157736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2004843",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Siu Lun Yu, RN
• Alexandra Zaballa, MD
• Emily Zacharias, DC
• Angelica Zaragoza
• Hannah Lynne Zerger
• Joy Y Zhao, MD
• Zhijie Zhou, MD
• Cassandra Zhu
• Yong Zhu, MD
• Daniel Pedro Ziperovich, MD

• Pediatric Dentistry in Burien, WA
• Providers in Burien, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.