EBRAHIM MIRJALILI DDS
NPI 1679650576
Dentist - General Practice in Buckley, WA

Q: What is Ebrahim Mirjalili's NPI number?

The NPI number for Ebrahim Mirjalili is 1679650576. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Q: What is Ebrahim Mirjalili's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Ebrahim Mirjalili was last updated on July 30, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since November 01, 2006PECOS Enrolled

2120 RYAN RD, BUCKLEY, WA 98321(360) 829-4920 Get Directions Write a Review

NPPES record last updated: July 30, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Ebrahim Mirjalili Dds NPPES

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

EBRAHIM MIRJALILI DDS (NPI 1679650576) is an individual general practice provider in Buckley, Washington, licensed in Washington (DE00007824) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679650576

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameEBRAHIM MIRJALILICredential: DDS

Location Address2120 RYAN RDBuckley, WA 98321

Mailing AddressPo Box 34703Seattle, WA 98124-1703 · (206) 764-0112 · Fax (206) 764-0489

Phone(360) 829-4920

Sole ProprietorNo

Enumeration DateNovember 1, 2006

Last NPPES UpdateJuly 30, 2018

✔ NPI 1679650576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in WA · DE00007824

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

2120 RYAN RD, Buckley, WA 98321

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Other Identifiers 3

Medicaid5025234WA

OtherMI9110WA · Regence Blue Shield

Other0175785WA · State Labor & Industries

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Humana.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ebrahim Mirjalili Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98321 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 10

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

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