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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: August 16, 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
Phone(360) 254-8151
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
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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.

DR. ERIC KUN KIM DDS
Dentist
300 SE 120TH AVE STE 500
VANCOUVER, WA 98683
Clark County (360) 254-8151
DR. MUNIB Y. DERHALLI D.M.D.
Dentist (Periodontics)
300 SE 120TH AVE STE 500
VANCOUVER, WA 98683
Clark County (360) 254-8151

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Periodontal Concepts's NPI number?

The NPI number for Periodontal Concepts is 1205041514. It was assigned to this organization in the NPPES registry on May 11, 2007.

Where is Periodontal Concepts located?

Periodontal Concepts is located at 300 SE 120th Ave Ste 500, Vancouver, WA 98683. The listed phone number is (360) 254-8151.

What is Periodontal Concepts's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Periodontal Concepts was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.