Dennis L Gibbs, D.D.S.
Individual provider Active NPI Dentist · Wasco, CA
NPI 1336346287 · NPPES record last updated Apr 13, 2010
Key facts
- NPI
- 1336346287
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 27133 (CA)
- Practice address
- Wasco State Prison
701 Scofield Ave
Wasco, CA 93280-8800 - Phone
- (661) 758-8400
- Fax
- (661) 758-7619
- NPI assigned
- Jul 2, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27133 | CA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 27133 | CA | Yes |
Addresses
Primary practice location
Wasco State Prison
701 Scofield Ave
Wasco, CA 93280-8800
Mailing address
701 Scofield Ave
Wasco, CA 93280-7515
Phone (661) 758-7015
Other providers in Wasco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.