Yendis L Gibson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019017102 Issued in IL

Practice address

3419 Dempster St
Skokie, IL 60076-2441

Phone

(847) 568-1337

Fax

(847) 568-1437

NPI assigned

Nov 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Yendis Gibson-King Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Skokie New Age Detnal

  • Dentist
  • Skokie, IL
  • NPI 1770756538
  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255402616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 WOODLAWN AVE",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600222122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 DEMPSTER ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762441",
            "telephone_number": "847-568-1337",
            "fax_number": "847-568-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "YENDIS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019017102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "019017102",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YENDIS",
            "last_name": "GIBSON-KING",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• GGL Healthcare Associates, PLLC
• Taleen Ghareeb Ghareebian, M.D
• Nadia Ghodsi, OTR/L
• Gi Specialists of the North Shore
• Candace Michelle Gibson, FNP
• Gideon Wellness PLLC
• Nicholas Aaron Giel
• Aneta Gil, PA-C
• Lainie Gilford, MSW
• Katie Marie Gilly, M.A.

• General Practice Dentistry in Skokie, IL
• Providers in Skokie, IL by specialty
• General Practice Dentistry in Illinois

• 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.

Verify at the official NPI Registry.