Chloe Marie Mirick, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE61090946 Issued in WA

Practice address

31231 3Rd Ave Ste 100
Black Diamond, WA 98010-9802

Phone

(360) 851-1288

Fax

(360) 851-1289

NPI assigned

Aug 30, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Chloe Marie Mirick Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Chloe Mirick DDS PLLC

  • General Practice Dentistry
  • Black Diamond, WA
  • NPI 1871214239
  NPD Authorized official

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

{
    "created_epoch": "1598745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1194338954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31231 3RD AVE STE 100",
            "city": "BLACK DIAMOND",
            "state": "WA",
            "postal_code": "980109802",
            "telephone_number": "360-851-1288",
            "fax_number": "360-851-1289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31231 3RD AVE STE 100",
            "city": "BLACK DIAMOND",
            "state": "WA",
            "postal_code": "980109802",
            "telephone_number": "360-851-1288",
            "fax_number": "360-851-1289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRICK",
        "first_name": "CHLOE",
        "middle_name": "MARIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-30",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61090946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHLOE",
            "last_name": "MIRICK",
            "middle_name": "MARIE",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Katie Kitzes
• Emily Marotzke
• Selwyne Jei C. Matillano, RN
• Rachel McKee, SLP
• Julia McMichael, MS, CCC-SLP
• Julie Lyn Murray, LMT
• Rebekah Nelson, CCC-SLP
• Nicole Mariah Nielsen, DPT
• Heather Nicole O'Brien, LMP
• Private Healthcare Facilities

• Dentist in Black Diamond, WA
• Providers in Black Diamond, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.