NPIMap

Organization Active NPI

Hooman Shakiba D.M.D.

  • Dentist
  • Vancouver, WA
National Provider Identifier
1841567062
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60242017 Issued in WA
Legal business name
HOOMAN SHAKIBA D.M.D.
Doing business as
Vancouver Family Dental
Practice address
217 SE 136TH Ave Ste 102
Vancouver, WA 98684-6908
Phone
(360) 896-9595
Fax
(360) 896-9703
NPI assigned
Nov 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Authorized official

Name
Dr. Hooman Shakiba, DMDNPI 1437388634
Title
Manager
Phone
(360) 896-9595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DE60242017 WA Primary

Addresses

Primary practice location

217 SE 136TH Ave Ste 102
Vancouver, WA 98684-6908

Mailing address

217 SE 136TH Ave Ste 102
Vancouver, WA 98684-6908
Phone (360) 896-9595

Other names 1

  • Vancouver Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

217 SE 136th Ave
Ste 102
Vancouver, WA 98684
Phone (360) 896-9595

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1841567062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 SE 136TH AVE STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846908",
            "telephone_number": "360-896-9595",
            "fax_number": "360-896-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 SE 136TH AVE STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846908",
            "telephone_number": "360-896-9595",
            "fax_number": "360-896-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOOMAN SHAKIBA D.M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "SHAKIBA",
        "authorized_official_first_name": "HOOMAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "360-896-9595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60242017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vancouver Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.