NPIMap

Organization Active NPI

Jason R. McGibony, DMD PC

  • General Practice Dentistry
  • Statesboro, GA
National Provider Identifier
1265659437
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN012077 Issued in GA
Legal business name
JASON R. MCGIBONY, DMD PC
Practice address
378 Savannah Ave
Statesboro, GA 30458-5163
Phone
(912) 764-4403
Fax
(912) 764-7210
NPI assigned
Apr 19, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jason Reid McGibony, DMDNPI 1952490989
Title
President
Phone
(912) 764-4403

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN012077 GA Primary

Addresses

Primary practice location

378 Savannah Ave
Statesboro, GA 30458-5163

Mailing address

378 Savannah Ave
Statesboro, GA 30458-5163
Phone (912) 764-4403

National Provider Directory

National Provider Directory

Locations

378 Savannah Ave
Statesboro, GA 30458
Phone (912) 764-4403

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265659437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 SAVANNAH AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585163",
            "telephone_number": "912-764-4403",
            "fax_number": "912-764-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 SAVANNAH AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585163",
            "telephone_number": "912-764-4403",
            "fax_number": "912-764-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON R. MCGIBONY, DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCGIBONY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "REID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-764-4403",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.