Active NPI
Jon Clark Giddings, D.D.S.
- Dentist
- Stephenville, TX
National Provider Identifier
1265753149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 25451
- Practice address
- 200 River North Blvd
Stephenville, TX 76401-1805 - Phone
- (254) 968-4200
- NPI assigned
- Jun 15, 2010
- Last updated
- Sep 23, 2016
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 25451 | TX | Primary |
Addresses
Primary practice location
200 River North Blvd
Stephenville, TX 76401-1805
Mailing address
200 River North Blvd
Stephenville, TX 76401-1805
Phone (254) 968-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 23, 2016 through Sep 23, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474588800000",
"number": "1265753149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 RIVER NORTH BLVD",
"city": "STEPHENVILLE",
"state": "TX",
"postal_code": "764011805",
"telephone_number": "254-968-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 RIVER NORTH BLVD",
"city": "STEPHENVILLE",
"state": "TX",
"postal_code": "764011805",
"telephone_number": "254-968-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIDDINGS",
"first_name": "JON",
"middle_name": "CLARK",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-15",
"last_updated": "2016-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "25451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stephenville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.