Pat and Amanda Dibble PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

DE60482588 Issued in WA

Legal business name

PAT AND AMANDA DIBBLE PLLC

Doing business as

Dibble Family Dental

Practice address

33801 1St Way S Ste 201
Federal Way, WA 98003-6219

Phone

(253) 838-4770

NPI assigned

Jun 20, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Patricio Rafael Dibble, D.M.D.NPI 1306175625

Title

Manager/Dentist

Phone

(253) 838-4770

Specialties & licenses 1

Addresses

Other names 1

• Dibble Family Dental Doing business as

Locations

Practitioners 3

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.

• Patricio Rafael Dibble, DMD

  • General Practice Dentistry
  • Minot, ND
  • NPI 1306175625
  NPD (past) Authorized official
• Amanda Olson Dibble, D.M.D.

  • General Practice Dentistry
  • Federal Way, WA
  • NPI 1912229782
  NPD (past)
• Richard L Koch, DDS

  • General Practice Dentistry
  • Federal Way, WA
  • NPI 1861475329
  NPD (past)

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1447600507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33801 1ST WAY S STE 201",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036219",
            "telephone_number": "253-838-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33801 1ST WAY S STE 201",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036219",
            "telephone_number": "253-838-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAT AND AMANDA DIBBLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "DIBBLE",
        "authorized_official_first_name": "PATRICIO",
        "authorized_official_middle_name": "RAFAEL",
        "authorized_official_title_or_position": "MANAGER/DENTIST",
        "authorized_official_telephone_number": "253-838-4770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60482588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dibble Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan Parr
• Katherine Elizabeth Partington, L.M.P.
• Brenda Partridge, BSN
• Eleanor Pascual, DNP, ARNP
• Marcie L Passic, OT/L
• David Patalano
• Aarohee Patel
• Nehal Prakash Patel, MD
• Payal Manu Patel, DMD
• Patricia Kho DDS, PLLC

• Dentist in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.