Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1043908510 Individual Practitioner Male Practitioner

Kevin Gardner

Dentist • Everett, WA

Professional Overview & Biography Verified Profile Summary

Kevin Gardner is a registered healthcare professional specializing in Dentist in Everett, WA. Practice services are available at 111 SE EVERETT MALL WAY BLDG D under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

111 Se Everett Mall Way Bldg D

Everett, WA 982083208

Telephone 4256673333
Associated Practice Facility / Clinic
🏢 Dongho Kim Dds Pllc Facility NPI 1154216380

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Everett, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.1 Yrs
Regional Practice Density
71 Specialists

Practicing in Everett, WA (2853 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-04-24
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License WA DENT.DE.61435584

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active April 24, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location April 24, 2023

Registered at 111 SE EVERETT MALL WAY BLDG D, EVERETT, WA 982083208 (Tel: 4256673333)

📍
Updated Business Mailing Address April 24, 2023

Registered at 12483 PERSONS RD, BOW, WA 982327202 (Tel: 3603917455)

👤
Provider Name / Credentials Updated April 24, 2023

Recorded as KEVIN GARDNER

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 24, 2023

Dentist (License #DENT.DE.61435584 in WA)

🟢
Initial NPI Registration & Enumeration April 24, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1043908510
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 24, 2023
Last Update: April 24, 2023
Sole Proprietor: Yes

Mailing Address

12483 Persons Rd

Bow, WA 982327202

Phone: 3603917455

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.