Active NPI
Andrew Hopkins Gibson, DDS
- Dentist
- Salisbury, MD
National Provider Identifier
1255436531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- LL504
- Practice address
- 1001 Lake St
Salisbury, MD 21801 - Phone
- (410) 334-3401
- Fax
- (410) 546-5090
- NPI assigned
- Sep 13, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | LL504 | MD | Primary |
| Dentist | 122300000X | 8379 | CO | |
| Dentist | 122300000X | 3615 | WV |
Addresses
Primary practice location
1001 Lake St
Salisbury, MD 21801
Mailing address
108 East Main Street
Wicomico County Health Department Village Dental Clinic
Salisbury, MD 21801
Phone (410) 334-3401
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9181301 | Other | MD | DORAL |
| 277384 | Other | MD | DBP |
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 |
|---|---|---|---|
| LL504 | MD | MD | Dentist |
| 8379 | CO | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255436531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 EAST MAIN STREET",
"address_2": "WICOMICO COUNTY HEALTH DEPARTMENT VILLAGE DENTAL CLINIC",
"city": "SALISBURY",
"state": "MD",
"postal_code": "21801",
"telephone_number": "410-334-3401",
"fax_number": "410-546-5090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 LAKE ST",
"city": "SALISBURY",
"state": "MD",
"postal_code": "21801",
"telephone_number": "410-334-3401",
"fax_number": "410-546-5090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "ANDREW",
"middle_name": "HOPKINS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "LL504",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "8379",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WV",
"license": "3615",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DORAL",
"identifier": "9181301",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DBP",
"identifier": "277384",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, MD
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.