Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1528739968 Individual Practitioner Female Practitioner

Dr. Mahtab Mansour , DDS

Dentist • Olympia, WA

Professional Overview & Biography Verified Profile Summary

Dr. Mahtab Mansour, DDS is a registered healthcare professional specializing in Dentist in Olympia, WA. Practice services are available at 4210 MARTIN WAY E STE 101 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4210 Martin Way E Ste 101

Olympia, WA 985165325

Telephone 3604559544
Associated Practice Facility / Clinic
🏢 Nurani, Mitchell, Kim, Pc Facility NPI 1699110494

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Olympia, WA

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

Practicing in Olympia, 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: 2025-12-19
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License WA 61198534

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Dr. Seok-Won (Sean) Chang , DMD

Dentist - General Practice

NPI 1184842155

Doctor of Dental Medicine

NPI 1386817567

Doctor of Dental Surgery

Dr. Susannah Bohannon , DMD

Dentist - General Practice

NPI 1538303284

Doctor of Dental Medicine

Dr. Trupa Patel , DMD

Dentist - General Practice

NPI 1780037564

Doctor of Dental Medicine

NPI 1932653185

Career & Practice History Timeline

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

7 Historical Events
👤
Provider Name / Credentials Updated December 19, 2025

Recorded as MAHTAB MANSOUR, DDS

NPI Profile Active September 24, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location September 24, 2021

Registered at 4210 MARTIN WAY E STE 101, OLYMPIA, WA 985165325 (Tel: 3604559544)

📍
Updated Business Mailing Address September 24, 2021

Registered at 4210 MARTIN WAY E STE 101, OLYMPIA, WA 985165325 (Tel: 3604559544)

👤
Provider Name / Credentials Updated September 24, 2021

Recorded as MAHTAB MANSOUR, DE 61198534

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 24, 2021

Dentist (License #61198534 in WA)

🟢
Initial NPI Registration & Enumeration September 24, 2021

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: 1528739968
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 24, 2021
Last Update: December 19, 2025
Sole Proprietor: Yes

Mailing Address

4210 Martin Way E Ste 101

Olympia, WA 985165325

Phone: 3604559544

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.