Organization Active NPI

John W Stieber DDS PS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Mill Creek, WA
National Provider Identifier
1215365580
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
JOHN W STIEBER DDS PS
Practice address
1025 153Rd St SE Ste 102
Mill Creek, WA 98012-4051
Phone
(425) 745-6322
Fax
(425) 743-0326
NPI assigned
Oct 24, 2013
Last updated
Oct 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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

Authorized official

Name
Ms. Karen R Gimse
Title
Practice Administrator
Phone
(425) 745-6322

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU Primary

Addresses

Primary practice location

1025 153Rd St SE Ste 102
Mill Creek, WA 98012-4051

Mailing address

1025 153Rd St SE Ste 102
Mill Creek, WA 98012-4051
Phone (425) 745-6322

Other identifiers 1

IdentifierTypeStateIssuer
1235361031OtherWANPI TYPE 1

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382572800000",
    "number": "1215365580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 153RD ST SE STE 102",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980124051",
            "telephone_number": "425-745-6322",
            "fax_number": "425-743-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 153RD ST SE STE 102",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980124051",
            "telephone_number": "425-745-6322",
            "fax_number": "425-743-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN W STIEBER DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-24",
        "last_updated": "2013-10-24",
        "status": "A",
        "authorized_official_last_name": "GIMSE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "425-745-6322",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1235361031",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.