NPIMap

Organization Active NPI

Quirt, Mongrain, Gibree, P.C.

Doing business as Edgewood Family Dentistry

  • Dentist
  • Edgewood, WA
National Provider Identifier
1992428395
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
QUIRT, MONGRAIN, GIBREE, P.C.
Doing business as
Edgewood Family Dentistry
Practice address
2222 Meridian Ave E Ste C
Edgewood, WA 98371-1032
Phone
(253) 952-6112
NPI assigned
Sep 21, 2022
Last updated
Sep 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
QUIRT, MONGRAIN, GIBREE, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Authorized official

Name
Hillary Thull
Title
Dia Team
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

2222 Meridian Ave E Ste C
Edgewood, WA 98371-1032

Mailing address

2222 Meridian Ave E Ste C
Edgewood, WA 98371-1032
Phone (253) 952-6112

Other names 1

  • Edgewood 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.

Locations

2222 Meridian Ave E
Ste C
Edgewood, WA 98371
Phone (253) 952-6112

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": "1663718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1992428395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 MERIDIAN AVE E STE C",
            "city": "EDGEWOOD",
            "state": "WA",
            "postal_code": "983711032",
            "telephone_number": "253-952-6112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 MERIDIAN AVE E STE C",
            "city": "EDGEWOOD",
            "state": "WA",
            "postal_code": "983711032",
            "telephone_number": "253-952-6112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUIRT, MONGRAIN, GIBREE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUIRT, MONGRAIN, GIBREE, P.C.",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "DIA TEAM",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgewood Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edgewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.