Individual provider Active NPI

Jayvon Hibbler, DDS

  • Dentist
  • Memphis, TN
National Provider Identifier
1275463275
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13310 Issued in TN
Practice address
3030 Covington Pike Ste 150
Memphis, TN 38128-5041
Phone
(901) 310-1441
NPI assigned
May 21, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13310 TN Primary

Addresses

Primary practice location

3030 Covington Pike Ste 150
Memphis, TN 38128-5041

Mailing address

2016 Steeplebrook Dr
Cordova, TN 38016-5075
Phone (901) 896-8745

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

NPI Registry JSON

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

{
    "created_epoch": "1779321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1275463275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 STEEPLEBROOK DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380165075",
            "telephone_number": "901-896-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 COVINGTON PIKE STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381285041",
            "telephone_number": "901-310-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBBLER",
        "first_name": "JAYVON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-21",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "13310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.