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DR. MUNIB Y. DERHALLI D.M.D.
NPI 1538239728
Dentist - Periodontics in Vancouver, WA

Active since November 08, 2006Opted out of Medicare · through Aug 18, 2027
300 SE 120TH AVE STE 500, VANCOUVER, WA 98683(360) 254-8151(360) 254-7175 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Dr. Munib Y. Derhalli D.m.d. NPPES

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

DR. MUNIB Y. DERHALLI D.M.D. (NPI 1538239728) is an individual periodontics provider in Vancouver, Washington, licensed in Washington (DE7432) and active in the NPI registry since November 2006. He has opted out of Medicare through August 18, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1538239728
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. MUNIB Y. DERHALLICredential: D.M.D.
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
Sole ProprietorNo
Enumeration DateNovember 8, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1538239728 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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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Munib Y. Derhalli D.m.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 18, 2015 through August 18, 2027.

Opt-Out Effective DateAugust 18, 2015
Opt-Out In Effect ThroughAugust 18, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98683 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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
PERIODONTAL CONCEPTS
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 Munib Derhalli's NPI number?

The NPI number for Munib Derhalli is 1538239728. It was assigned to this individual provider in the NPPES registry on November 8, 2006.

Where is Munib Derhalli located?

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

What is Munib Derhalli's specialty?

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

Is Munib Derhalli enrolled in Medicare?

No. Munib Derhalli has opted out of Medicare through August 18, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Munib Derhalli was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.