NPIMap

Individual provider Active NPI

Steven Douglas Kimberley, D.M.D.

  • Pediatric Dentistry
  • Bellingham, WA
National Provider Identifier
1841587581
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
55518 Issued in WA
Practice address
3300 Squalicum Pkwy Ste 200
Bellingham, WA 98225-1956
Phone
(360) 733-7708
Fax
(360) 733-9207
NPI assigned
Jul 1, 2011
Last updated
Jul 1, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 55518 WA Primary

Addresses

Primary practice location

3300 Squalicum Pkwy Ste 200
Bellingham, WA 98225-1956

Mailing address

3300 Squalicum Pkwy Ste 200
Bellingham, WA 98225-1956
Phone (360) 733-7708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
55518WAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Chad Hugh Galbraith DDS PS Pediatric Dentistry Past Accepting new patients
Steven D Kimberley DMD PC Pediatric Dentistry Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309478400000",
    "number": "1841587581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 SQUALICUM PKWY STE 200",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251956",
            "telephone_number": "360-733-7708",
            "fax_number": "360-733-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 SQUALICUM PKWY STE 200",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251956",
            "telephone_number": "360-733-7708",
            "fax_number": "360-733-9207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBERLEY",
        "first_name": "STEVEN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "55518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.