Landon King DDS Justin Vanbibber DMD PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LANDON KING DDS JUSTIN VANBIBBER DMD PLLC

Practice address

17415 Pacific Ave S Ste Ab
Spanaway, WA 98387-8200

Phone

(360) 907-9662

NPI assigned

Oct 8, 2024

Organization subpart

No

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

Authorized official

Name

Landon King, DDSNPI 1164805610

Title

Owner

Phone

(360) 907-9662

Specialties & licenses 1

Addresses

Other names 1

• SmallFoot Kids Dental 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.

• Landon George King, D.D.S.

  • Dentist
  • Camas, WA
  • NPI 1164805610
  NPD Authorized official

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1851110746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 NW JASMINE ST",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986074403",
            "telephone_number": "801-231-6682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17415 PACIFIC AVE S STE AB",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983878200",
            "telephone_number": "360-907-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDON KING DDS JUSTIN VANBIBBER DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "LANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-907-9662",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SmallFoot Kids Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Simone Alexandria Koger, LMFT
• Jake Kopitzke, SSP
• Kwansoo Lee, DDS, PLLC
• Dennis Kim Kwon, DDS
• Kelsie Ann Landers, MS, OTR/L
• Kwansoo Lee, D.D.S.
• Peter John Lefeau, M.S.W.
• Ying Li
• Candice Dawn Liedes, OTR/L
• Erica G. Lightbody

• Dentist in Spanaway, WA
• Providers in Spanaway, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.