NPIMap

Organization Active NPI

Dental Professionals of Washington, Quirt, Mongrain, Gibree, PC

  • General Practice Dentistry
  • Ridgefield, WA
National Provider Identifier
1609737733
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC
Practice address
420 N 56TH PL Unit 150
Ridgefield, WA 98642-3504
Phone
(564) 236-2950
Fax
(564) 236-2065
NPI assigned
Nov 19, 2025
Last updated
Nov 19, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

420 N 56TH PL Unit 150
Ridgefield, WA 98642-3504

Mailing address

420 N 56TH PL Unit 150
Ridgefield, WA 98642-3504
Phone (564) 236-2950

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
Dental Professionals of Washington 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

420 N 56th Pl
Unit 150
Ridgefield, WA 98642
Phone (564) 236-2950

NPI Registry JSON

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

{
    "created_epoch": "1763510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1609737733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N 56TH PL UNIT 150",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986423504",
            "telephone_number": "564-236-2950",
            "fax_number": "564-236-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N 56TH PL UNIT 150",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986423504",
            "telephone_number": "564-236-2950",
            "fax_number": "564-236-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF WASHINGTON, QUIRT, MONGRAIN, GIBREE, PC",
        "enumeration_date": "2025-11-19",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; 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.