Glenn Edward Gibson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

33091 Issued in CA

Practice address

885 Canarios CT
Suite 204
Chula Vista, CA 91910-7877

Phone

(619) 216-9481

Fax

(619) 216-9461

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Glenn E. Gibson, DDS

  • General Practice Dentistry
  • Chula Vista, CA
  • NPI 1386882215
  NPD (past) Authorized official

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144381427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 CANARIOS CT",
            "address_2": "SUITE 204",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107877",
            "telephone_number": "619-216-9481",
            "fax_number": "619-216-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 CANARIOS CT",
            "address_2": "SUITE 204",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107877",
            "telephone_number": "619-216-9481",
            "fax_number": "619-216-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "GLENN",
        "middle_name": "EDWARD",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Thomas Gettelfinger, PT
• Simin M Ghahremani, M.D.
• Marlin E Gher Jr., D.D.S.
• Marygrace Youssef Ghosn
• Gia Dental Inc
• Nicholas Lane Gibson, DC
• Samuel Cyrus Gidanian, MD
• Lauren Gideon, APCC
• Bethany Gifford, OTR/L
• Jose Carlos Gil Garcia

• General Practice Dentistry in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.