Garibov, PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

GARIBOV, PLLC

Doing business as

Columbia River Implants and Periodontics

Practice address

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

Phone

(360) 524-4236

Fax

(360) 397-6867

NPI assigned

Aug 12, 2021

Last updated

Aug 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mikhail Garibov, DDS MSDNPI 1376944314

Title

Member

Phone

(360) 513-6244

Specialties & licenses 1

Addresses

Other names 1

• Columbia River Implants and Periodontics Doing business as

Locations

Practitioners 1

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.

• Mikhail Garibov, DDS, MSD

  • Periodontics
  • Vancouver, WA
  • NPI 1376944314
  NPD Authorized official

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1831864727",
    "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": "360-524-4236",
            "fax_number": "360-397-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARIBOV, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "GARIBOV",
        "authorized_official_first_name": "MIKHAIL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "360-513-6244",
        "authorized_official_credential": "DDS MSD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia River Implants and Periodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• Periodontics in Vancouver, WA
• Providers in Vancouver, WA by specialty
• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.