NPIMap

Organization Active NPI

Quirt, Mongrain, Gibree, P.C.

Doing business as Stanwood Advanced Family Dentistry

  • General Practice Dentistry
  • Stanwood, WA
National Provider Identifier
1932700663
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
QUIRT, MONGRAIN, GIBREE, P.C.
Doing business as
Stanwood Advanced Family Dentistry
Practice address
9628 271St St NW
Stanwood, WA 98292-8096
Phone
(360) 629-4597
NPI assigned
Nov 9, 2020
Last updated
Nov 9, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
HEARTLAND DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Authorized official

Name
Tabatha Lemke
Title
Credentialing Coordinator
Phone
(217) 540-6078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

9628 271St St NW
Stanwood, WA 98292-8096

Mailing address

9628 271St St NW
Stanwood, WA 98292-8096

Other names 1

  • Stanwood Advanced Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Quirt Mongrain Gibree PC5 organizations share this tax ID, including this one
Part of
Quirt Mongrain Gibree PC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1932700663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9628 271ST ST NW",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982928096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9628 271ST ST NW",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982928096",
            "telephone_number": "360-629-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUIRT, MONGRAIN, GIBREE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND DENTAL",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "LEMKE",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6078"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanwood Advanced Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stanwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.