NPIMap

Organization Active NPI

Harbor Kids Dental

  • Dentist
  • Olympia, WA
National Provider Identifier
1942686845
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60282727 Issued in WA
Legal business name
HARBOR KIDS DENTAL
Practice address
108 22ND Ave SW Ste 16
Olympia, WA 98501-2871
Phone
(360) 943-5775
NPI assigned
Aug 4, 2015
Last updated
Aug 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Authorized official

Name
Justin Vanbibber, DMD
Title
Owner
Phone
(360) 943-5775

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60282727 WA Primary

Addresses

Primary practice location

108 22ND Ave SW Ste 16
Olympia, WA 98501-2871

Mailing address

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1942686845",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 22ND AVE SW STE 16",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985012871",
            "telephone_number": "360-943-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR KIDS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "VANBIBBER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-943-5775",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60282727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.