Timothy Quirt, Mongrain, Gibree, P.C.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

TIMOTHY QUIRT, MONGRAIN, GIBREE, P.C.

Doing business as

Main Street Dental Care

Practice address

623 W Main St
Monroe, WA 98272-2101

Phone

(360) 805-9060

NPI assigned

Oct 16, 2024

Organization subpart

Yes

Parent organization

TIMOTHY QUIRT, MONGRAIN, GIBREE, P.C.As reported in NPPES

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

Authorized official

Name

Cemyira McDougal

Title

Credentialing Coordinator

Phone

(217) 764-8609

Specialties & licenses 1

Addresses

Other names 1

• Main Street Dental Care Doing business as

Part of

Timothy Quirt Mongrain Gibree PC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derek Park, DDS

  • General Practice Dentistry
  • Monroe, WA
  • NPI 1700778172
  NPD

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1275353989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 W MAIN ST",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982722101",
            "telephone_number": "360-805-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 W MAIN ST",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982722101",
            "telephone_number": "360-805-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY QUIRT, MONGRAIN, GIBREE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TIMOTHY QUIRT, MONGRAIN, GIBREE, P.C.",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "MCDOUGAL",
        "authorized_official_first_name": "CEMYIRA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-764-8609"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Street Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bridget B Thorpe
• Michelle Thorsteinson, M.S.
• Thrifty Payless Inc
• Andrew Thurman, M.D.
• Melissa Ann Tietje, LMP
• Hanh To, PHARMD
• Rene Tobin
• Melinda M Tonelli, M.D.
• Margarita Rosa Toro Gonzalez, CG61349567
• Rochelle Conway Toulouse, M.A.

• Dentist in Monroe, WA
• Providers in Monroe, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.