NPIMap

Organization Active NPI

Dental Professionals of Washington Quirt Mongrain Gibree PC

Doing business as Duvall Dental Center

  • General Practice Dentistry
  • Duvall, WA
National Provider Identifier
1225790819
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC
Doing business as
Duvall Dental Center
Practice address
14703 1St LN NE Ste 203
Duvall, WA 98019-8470
Phone
(425) 307-4546
NPI assigned
Oct 11, 2021
Last updated
Oct 11, 2021By the provider in NPPES
Organization subpart
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

14703 1St LN NE Ste 203
Duvall, WA 98019-8470

Mailing address

14703 1St LN NE Ste 203
Duvall, WA 98019-8470

Other names 1

  • Duvall Dental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Washington Quirt Mongrain Gibree PC29 organizations share this tax ID, including this one
Part of
Dental Professionals of Washington Quirt Mongrain Gibree PC

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

14703 1st Ln NE
Ste 203
Duvall, WA 98019
Phone (425) 307-4546

NPI Registry JSON

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1225790819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14703 1ST LN NE STE 203",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980198470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14703 1ST LN NE STE 203",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980198470",
            "telephone_number": "425-307-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC",
        "organizational_subpart": "YES",
        "enumeration_date": "2021-10-11",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duvall Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duvall, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.