Active NPI
Joel P. Gardner, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Mount Vernon, WA
National Provider Identifier
1265657522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DE00008421
- Practice address
- 1210 E Division St
Mount Vernon, WA 98274-4102 - Phone
- (360) 336-5464
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DE00008421 | WA | Primary |
Addresses
Primary practice location
1210 E Division St
Mount Vernon, WA 98274-4102
Mailing address
1210 E Division St
Mount Vernon, WA 98274-4102
Phone (360) 336-5464
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58421 | Other | WA | WASHINGTON DENTAL SERVICE |
| 518176 | Other | WA | UNITED CONCORDIA TRICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00008421 | WA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Stanwood, WA
- NPI 1639305253
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773964800000",
"number": "1265657522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 E DIVISION ST",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982744102",
"telephone_number": "360-336-5464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 E DIVISION ST",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982744102",
"telephone_number": "360-336-5464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "JOEL",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-13",
"last_updated": "2026-03-20",
"certification_date": "2026-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "WA",
"license": "DE00008421",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON DENTAL SERVICE",
"identifier": "58421",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA TRICARE",
"identifier": "518176",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.