NPIMap

Organization Active NPI

Implant & Periodontic Specialists

  • Periodontics
  • Bellevue, WA
National Provider Identifier
1225445539
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
IMPLANT & PERIODONTIC SPECIALISTS
Practice address
1418 112TH Ave NE Suite 100
Bellevue, WA 98004
Phone
(425) 453-1010
Fax
(425) 637-8704
NPI assigned
Jul 18, 2014
Last updated
Jul 18, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
IMPLANT & PERIODONTIC SPECIALISTSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Authorized official

Name
Mrs. Jill Klaiber
Title
Office Manager
Phone
(425) 453-1010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X NU Primary

Addresses

Primary practice location

1418 112TH Ave NE Suite 100
Bellevue, WA 98004

Mailing address

1418 112TH Ave NE Suite 100
Bellevue, WA 98004
Phone (425) 453-1010

National Provider Directory

National Provider Directory
Part of
Implant Periodontic Specialists

Practitioners & affiliated clinicians

Practitioners 5

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": "1405641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405641600000",
    "number": "1225445539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 112TH AVE NE SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-453-1010",
            "fax_number": "425-637-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 112TH AVE NE SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-453-1010",
            "fax_number": "425-637-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPLANT & PERIODONTIC SPECIALISTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMPLANT & PERIODONTIC SPECIALISTS",
        "enumeration_date": "2014-07-18",
        "last_updated": "2014-07-18",
        "status": "A",
        "authorized_official_last_name": "KLAIBER",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-453-1010",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.