Gibree, Quirt, Mongrain, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GIBREE, QUIRT, MONGRAIN, P.C.

Doing business as

Southpoint Dental Center

Practice address

1129 S 2ND Ave Ste a
Walla Walla, WA 99362-4100

Phone

(509) 522-2522

NPI assigned

Sep 3, 2021

Organization subpart

Yes

Parent organization

GIBREE, QUIRT, MONGRAIN, P.C.As reported in NPPES

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

Authorized official

Name

Hannah Fish

Title

Credentialing Manager

Phone

(217) 540-5699

Specialties & licenses 1

Addresses

Other names 1

• Southpoint Dental Center Doing business as

Part of

Gibree Quirt Mongrain PC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Ross Gustavsen, DDS

  • General Practice Dentistry
  • Walla Walla, WA
  • NPI 1457431025
  NPD (past)

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680048000000",
    "number": "1942978986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 S 2ND AVE STE A",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 S 2ND AVE STE A",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624100",
            "telephone_number": "509-522-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBREE, QUIRT, MONGRAIN, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GIBREE, QUIRT, MONGRAIN, P.C.",
        "enumeration_date": "2021-09-03",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "217-540-5699"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southpoint Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric Geil, M.D.
• George Elmenhurst DC PS (Elmenhurst Chiropractic Clinic)
• Ruth Pula Gerola, M.D.
• Ghorbanian PLLC
• Megan Marie Gibbs, AGACNP-BC
• Michael Dean Gibson
• Arthur W Giebel, MD
• Andrea Giedeman, MSPT
• Tuesdee Gies
• Michael Wade Gillespie, M.D.

• General Practice Dentistry in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.