Active NPI
James Isaac Gibson III, D.D.S., M.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Henderson, NV
National Provider Identifier
1245335819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- S3-97
- Practice address
- 70 East Horizon Ridge
Henderson, NV 89015 - Phone
- (775) 223-3309
- NPI assigned
- Sep 14, 2006
- Last updated
- Jul 8, 2007
- 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 | S3-97 | NV | Primary |
Addresses
Primary practice location
70 East Horizon Ridge
Henderson, NV 89015
Mailing address
838 Park Lane
Henderson, NV 89015
Phone (702) 565-0085
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S3-97 | NV | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245335819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "838 PARK LANE",
"city": "HENDERSON",
"state": "NV",
"postal_code": "89015",
"telephone_number": "702-565-0085",
"fax_number": "702-566-8248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 EAST HORIZON RIDGE",
"city": "HENDERSON",
"state": "NV",
"postal_code": "89015",
"telephone_number": "775-223-3309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "JAMES",
"middle_name": "ISAAC",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "D.D.S., M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NV",
"license": "S3-97",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
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.