Mongrain, Quirt, Gibree, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MONGRAIN, QUIRT, GIBREE, P.C.

Practice address

14142 Main St NE Ste 104
Duvall, WA 98019-9007

Phone

(425) 318-7689

NPI assigned

Aug 12, 2021

Organization subpart

Yes

Parent organization

HEARTLAND DENTALAs reported in NPPES

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

Addresses

Other names 1

• Duvall Family Dental Doing business as

Part of

Mongrain Quirt Gibree PC

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1821763897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14142 MAIN ST NE STE 104",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980199007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14142 MAIN ST NE STE 104",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980199007",
            "telephone_number": "425-318-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONGRAIN, QUIRT, GIBREE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND DENTAL",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duvall Family Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Duvall Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey Paul Metcalf, DC
• Kara Meyer, MS, LMHC
• Phillip Edward Milam, MD
• Shadrian Mills
• Kristi S. Moffat, MD
• Victoria N Morgan, M.A. LMHCA
• Keely Murphy, LMP
• Muscle Rehab Massage
• Mwines Physical Therapy PLLC
• Caron Louise Nelson, DDS

• General Practice Dentistry in Duvall, WA
• Providers in Duvall, 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 Sep 17, 2021; 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.