NPIMap

Organization Active NPI

Harbor Kids Dental PLLC

  • General Practice Dentistry
  • Aberdeen, WA
National Provider Identifier
1851775514
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE60282727 Issued in WA
Legal business name
HARBOR KIDS DENTAL PLLC
Practice address
216 W Heron St
Aberdeen, WA 98520-6225
Phone
(360) 532-5437
NPI assigned
Jul 13, 2015
Last updated
Jul 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Authorized official

Name
Dr. Justin Vanbibber, DMDNPI 1356641161
Title
Owner
Phone
(801) 231-6682

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE60282727 WA Primary

Addresses

Primary practice location

216 W Heron St
Aberdeen, WA 98520-6225

Mailing address

1148 72ND St E
Suite B
Tacoma, WA 98404-1705
Phone (253) 537-5437

National Provider Directory

National Provider Directory

Locations

216 W Heron St
Aberdeen, WA 98520
Phone (360) 532-5437

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1851775514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 72ND ST E",
            "address_2": "SUITE B",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984041705",
            "telephone_number": "253-537-5437",
            "fax_number": "253-537-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 W HERON ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985206225",
            "telephone_number": "360-532-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR KIDS DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "VANBIBBER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-231-6682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60282727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; 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.