NPIMap

Organization Active NPI

Timothy Quirt, Mongrain, Gibree, P.C.

Doing business as Enso Dentistry

  • General Practice Dentistry
  • Redmond, WA
National Provider Identifier
1326687237
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TIMOTHY QUIRT, MONGRAIN, GIBREE, P.C.
Doing business as
Enso Dentistry
Practice address
15446 Bel Red Rd Ste 100
Redmond, WA 98052-5503
Phone
(425) 558-3676
NPI assigned
Dec 26, 2019
Last updated
Feb 2, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
TIMOTHY QUIRT, MONGRAIN, GIBREE, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

15446 Bel Red Rd Ste 100
Redmond, WA 98052-5503

Mailing address

15446 Bel Red Rd Ste 100
Redmond, WA 98052-5503

Other names 1

  • Enso Dentistry 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
Timothy 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

15446 Bel Red Rd
Ste 100
Redmond, WA 98052
Phone (425) 558-3676

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1326687237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15446 BEL RED RD STE 100",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15446 BEL RED RD STE 100",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525503",
            "telephone_number": "425-558-3676"
        }
    ],
    "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": "2019-12-26",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "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": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enso Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Enso Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.