Individual provider Active NPI

Ryan B Gibson, DMD

  • Endodontics
  • Abilene, TX
National Provider Identifier
1316304827
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
32464 Issued in TX
Practice address
5849 Buffalo Gap Rd Ste C
Abilene, TX 79606-1264
Phone
(325) 704-5001
Fax
(325) 704-5141
NPI assigned
Jan 28, 2016
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 32464 TX Primary

Addresses

Primary practice location

5849 Buffalo Gap Rd Ste C
Abilene, TX 79606-1264

Mailing address

5849 Buffalo Gap Rd Ste C
Abilene, TX 79606-1264
Phone (326) 959-9704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180830002704 MI Order and Referring Only - DentistPractitioner - Dentist 9931459609

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Abilene Endodontics, PC Endodontics CurrentSince Jan 14, 2024 Accepting new patients

Locations

5849 Buffalo Gap Rd
Ste C
Abilene, TX 79606
Phone (325) 704-5001

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1316304827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5849 BUFFALO GAP RD STE C",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061264",
            "telephone_number": "326-959-9704",
            "fax_number": "432-695-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5849 BUFFALO GAP RD STE C",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061264",
            "telephone_number": "325-704-5001",
            "fax_number": "325-704-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "RYAN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-28",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "32464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.