Active NPI
John Phillip Gibbs, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Burlingame, CA
National Provider Identifier
1164775615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 13802
- Practice address
- 500 Primrose Rd
Burlingame, CA 94010-4088 - Phone
- (650) 342-5801
- Fax
- (650) 342-5803
- NPI assigned
- Oct 22, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 13802 | CA | Primary |
Addresses
Primary practice location
500 Primrose Rd
Burlingame, CA 94010-4088
Mailing address
500 Primrose Rd
Burlingame, CA 94010-4088
Phone (650) 342-5801
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 942145254 | Other | CA | DELTA DENTAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13802 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350864000000",
"number": "1164775615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 PRIMROSE RD",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940104088",
"telephone_number": "650-342-5801",
"fax_number": "650-342-5803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 PRIMROSE RD",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940104088",
"telephone_number": "650-342-5801",
"fax_number": "650-342-5803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "JOHN",
"middle_name": "PHILLIP",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-22",
"last_updated": "2012-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "13802",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL",
"identifier": "942145254",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlingame, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.