Active NPI
Joel D Gibson, DMD PA
- General Practice Dentistry
- Rosedale, MS
National Provider Identifier
1215068630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 207684
- Practice address
- 512 Levee St
Rosedale, MS 38769 - Phone
- (662) 759-6603
- NPI assigned
- Mar 8, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 207684 | MS | Primary |
Addresses
Primary practice location
512 Levee St
Rosedale, MS 38769
Mailing address
PO Box 820
Rosetale, MS 38769
Phone (662) 759-6603
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207684 | MS | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215068630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 820",
"city": "ROSETALE",
"state": "MS",
"postal_code": "38769",
"telephone_number": "662-759-6603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 LEVEE ST",
"city": "ROSEDALE",
"state": "MS",
"postal_code": "38769",
"telephone_number": "662-759-6603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "JOEL",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DMD PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MS",
"license": "207684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rosedale, MS
- Angel of Mercy Hospice
- Valerie Orcutt Antici, FNP
- Bolivar Physician Practices LLC (Rosedale Family Medical)
- Delta Health Center, Inc (DHC - Rosedale)
- Essential School Based Health Clinic
- Joy's Loving Care Adult Daycare Center
- John William Lewis Jr., MD
- Karminee Love, LPC
- Mississippi State Department of Health
- Rosedale Family Medical Center, P.C.
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.