Provider Demographics
NPI:1245384445
Name:FUHRIMAN, KIRK ERNEST (DDS)
Entity type:Individual
Prefix:MR
First Name:KIRK
Middle Name:ERNEST
Last Name:FUHRIMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N. EVERGREEN RD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-0993
Mailing Address - Country:US
Mailing Address - Phone:509-891-9011
Mailing Address - Fax:509-891-8999
Practice Address - Street 1:420 N. EVERGREEN RD.
Practice Address - Street 2:SUITE 200
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-0993
Practice Address - Country:US
Practice Address - Phone:509-891-9011
Practice Address - Fax:509-891-8999
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010409122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADE00010409OtherSTATE DENTIST LICENSE
WA5055652Medicaid