PERIODONTAL CONCEPTS
NPI 1205041514
Dentist - Periodontics in Vancouver, WA

Active since May 11, 2007
300 SE 120TH AVE STE 500, VANCOUVER, WA 98683(360) 254-8151(360) 254-7175 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Periodontal Concepts NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PERIODONTAL CONCEPTS (NPI 1205041514) is a healthcare organization registered as a periodontics in Vancouver, Washington and active in the NPI registry since May 2007. The organization lists Munib Y. Derhalli, President, as its authorized official.

NPPES Registry Identity

NPI1205041514
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NamePERIODONTAL CONCEPTS
Location Address300 SE 120TH AVE STE 500Vancouver, WA 98683-4020
Mailing Address300 Se 120th Ave Ste 500Vancouver, WA 98683-4020 · (360) 254-8151 · Fax (360) 254-7175
Fax(360) 254-7175
Organization SubpartNo
Authorized OfficialMunib Y. DerhalliPresident · (360) 254-8151
Enumeration DateMay 11, 2007
Last NPPES UpdateAugust 22, 2020
NPI 1205041514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License Licensed in WA · DE7432
Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

300 SE 120TH AVE STE 500, Vancouver, WA 98683

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (Periodontics)
300 SE 120TH AVE STE 500
VANCOUVER, WA 98683
Dentist
300 SE 120TH AVE STE 500
VANCOUVER, WA 98683

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205041514, enumerated as an "organization" on May 11, 2007.

The provider is located at 300 SE 120TH AVE STE 500 VANCOUVER, WA 98683 and the phone number is (360) 254-8151.

Dentist with taxonomy code 1223P0300X and a focus in Periodontics.