Mikhail Garibov, DDS, MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DE60464667 Issued in WA

Practice address

9300 NE Vancouver Mall Dr Ste 205
Vancouver, WA 98662-8201

Phone

(360) 513-6244

NPI assigned

Sep 9, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Garibov, PLLC

  • Periodontics
  • Vancouver, WA
  • NPI 1831864727
  NPD Authorized official

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1376944314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 READING ST SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985013084",
            "telephone_number": "360-513-6244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 NE VANCOUVER MALL DR STE 205",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986628201",
            "telephone_number": "360-513-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARIBOV",
        "first_name": "MIKHAIL",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-09",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE60464667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Gardner
• Hallie Blyn Gardner, M.D.
• Cristina Garduque
• Tracy Garell
• Michelle Garibo
• Garibov, PLLC
• Kevin Garland, MD
• Hannah Marie Garner
• Hillary Garner, RDH, BSDH
• Kate Leigh Garner, LMP

• All providers in Vancouver, WA
• Periodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.