Evergreen Endodontics PLLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

EVERGREEN ENDODONTICS PLLC

Doing business as

Evergreen Endodontics

Practice address

600 NW Gilman Blvd Ste a
Issaquah, WA 98027-2445

Phone

(425) 697-9777

Fax

(425) 697-9778

NPI assigned

Oct 17, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Nima Dejbod, DMD

Title

Owner

Phone

(425) 697-9777

Specialties & licenses 1

Addresses

Other names 1

• Evergreen Endodontics Doing business as

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508198400000",
    "number": "1255842274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NW GILMAN BLVD STE A",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272445",
            "telephone_number": "425-697-9777",
            "fax_number": "425-697-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NW GILMAN BLVD STE A",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272445",
            "telephone_number": "425-697-9777",
            "fax_number": "425-697-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN ENDODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-17",
        "status": "A",
        "authorized_official_last_name": "DEJBOD",
        "authorized_official_first_name": "NIMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-697-9777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Eummer
• Christian Jean Eustaquio
• Elisabeth L Evans, MD
• Jacqueline P Evans, CRNA, ARNP
• Karen Blue Evenson, PT
• Evergreen Urology Consultants LLC
• Bentley Richard Everingham, RNFA
• Iveta Everingham, RNFA
• Alyssa Joy Ewell, CF- SLP
• Keesha Ewers, ARNP

• Endodontics in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Endodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.