Dental Professionals of Washington Quirt Mongrain Gibree PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PC

Practice address

23805 Highway 99 Ste 100
Edmonds, WA 98026-9204

Phone

(425) 778-6333

NPI assigned

Sep 20, 2019

Organization subpart

Yes

Parent organization

DENTAL PROFESSIONALS OF WASHINGTON QUIRT MONGRAIN GIBREE PCAs reported in NPPES

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

Authorized official

Name

Tabatha Lemke

Title

Credentialing Coordinator

Phone

(217) 540-6078

Specialties & licenses 1

Addresses

Other names 1

• Dental Care of Edmonds Doing business as

Part of

Dental Professionals of Washington Quirt Mongrain Gibree PC

Locations

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605830400000",
    "number": "1760033807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23805 HIGHWAY 99 STE 100",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980269204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23805 HIGHWAY 99 STE 100",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980269204",
            "telephone_number": "425-778-6333"
        }
    ],
    "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": "2019-09-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A",
        "authorized_official_last_name": "LEMKE",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6078"
    },
    "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": "Dental Care of Edmonds",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carlos Del Rio
• George R Delaney, MD
• Emebet Demisse, RN
• Kelly Lynn Dempsey, ARNP
• John A. Deninno, PH.D.
• Shauna Anne Dentler, MD
• Alexis J Desenberg
• Janet Lynn Determan, OT
• Nicholas S. Dichiara, PA-C
• Braden Jeffrey Dick, DPT

• General Practice Dentistry in Edmonds, WA
• Providers in Edmonds, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.