Peter Nabegh N Ghattas, D.P.D

Primary specialty

DenturistTaxonomy code 122400000X

License

DN00000199 Issued in WA

Practice address

2811 E Main
Puyallup, WA 98372-3167

Phone

(253) 770-7707

Fax

(253) 770-8784

NPI assigned

Mar 15, 2007

Sex

Male

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A New Image Denture Clinic

  • Denturist
  • Puyallup, WA
  • NPI 1003237538
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306970801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 E MAIN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723167",
            "telephone_number": "253-770-7707",
            "fax_number": "253-770-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 E MAIN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723167",
            "telephone_number": "253-770-7707",
            "fax_number": "253-770-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHATTAS",
        "first_name": "PETER NABEGH",
        "middle_name": "N",
        "credential": "D.P.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "WA",
            "license": "DN00000199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5027412",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dean Raymond Gerimonte II, D.C.
• Neva Anne Gerke, LM, MSM
• Emily Marie Germiat, DPT
• Tonya Sue Gervacio
• Jon Getbehead, D.C.
• Simranjeet Ghuman, PHARM.D.
• Ericka Marie Gianotto, ARNP, FNP-C, DNP
• Curren Elliott Giberson, MD
• Kristie L Gibney, MA CCC-SLP
• Kimberley Ann Gibson, R.D.H.

• All providers in Puyallup, WA
• Denturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.