Individual provider Active NPI

India D Gibson, DDS

  • Dentist
  • Sugar Land, TX
National Provider Identifier
1174775613
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5931 Issued in LA
Practice address
7320 Highway 90a Ste 290
Sugar Land, TX 77478-3597
Phone
(832) 930-7858
Fax
(832) 939-8171
NPI assigned
Oct 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5931 LA Primary

Addresses

Primary practice location

7320 Highway 90a Ste 290
Sugar Land, TX 77478-3597

Mailing address

7320 Highway 90a Ste 290
Sugar Land, TX 77478-3597
Phone (832) 930-7858

Other identifiers 2

IdentifierTypeStateIssuer
5931OtherLALA STATE LICENSE
24202OtherTXTEXAS STATE LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150803001746 CA Order and Referring Only - DentistPractitioner - Dentist 3375857451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5931LAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bella Smiles Cosmetic and Family Dentistry PLLC Dentist PastSince Oct 3, 2016 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174775613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 HIGHWAY 90A STE 290",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783597",
            "telephone_number": "832-930-7858",
            "fax_number": "832-939-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 HIGHWAY 90A STE 290",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783597",
            "telephone_number": "832-930-7858",
            "fax_number": "832-939-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "INDIA",
        "middle_name": "D",
        "name_prefix": "Miss",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "5931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA STATE LICENSE",
            "identifier": "5931",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE LICENSE",
            "identifier": "24202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.