Individual provider Active NPI

Kumi Ebihara, DMD

  • Dentist
  • Monroe, WA
National Provider Identifier
1891077467
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN03134 Issued in RI
Practice address
128 N Blakeley St
Monroe, WA 98272-1823
Phone
(360) 794-8292
NPI assigned
Sep 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DENT.DE.61218276 WA
Dentist 122300000X DEN03134 RI Primary

Addresses

Primary practice location

128 N Blakeley St
Monroe, WA 98272-1823

Mailing address

3123 Falkland Rd
Carrollton, TX 75007-3512
Phone (917) 684-9411

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
DEN03134RIMDDentist
DENT.DE.61218276WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1891077467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3123 FALKLAND RD",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750073512",
            "telephone_number": "917-684-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 N BLAKELEY ST",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721823",
            "telephone_number": "360-794-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBIHARA",
        "first_name": "KUMI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-09",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DENT.DE.61218276",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "RI",
            "license": "DEN03134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.