W.Sidney Gibson, DDS, PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

3921 Issued in NC

Legal business name

W.SIDNEY GIBSON, DDS, PA

Practice address

904 Spivey Rd
Whiteville, NC 28472-2915

Phone

(910) 642-7741

Fax

(910) 640-2373

NPI assigned

Jan 16, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Wendy Grice Bullard

Title

Receptionist

Phone

(910) 642-7741

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1013193465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 SPIVEY RD",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284722915",
            "telephone_number": "910-642-7741",
            "fax_number": "910-640-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 SPIVEY RD",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284722915",
            "telephone_number": "910-642-7741",
            "fax_number": "910-640-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W.SIDNEY GIBSON, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "BULLARD",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "GRICE",
        "authorized_official_title_or_position": "RECEPTIONIST",
        "authorized_official_telephone_number": "910-642-7741",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NC",
            "license": "3921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8993181",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Whiteville, NC
• Providers in Whiteville, NC by specialty
• Dental Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.