Individual provider Active NPI

T. Michael Gibson, DDS

  • General Practice Dentistry
  • The Woodlands, TX
National Provider Identifier
1386652568
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14758 Issued in TX
Practice address
3 Grogans Park Dr
Ste: 100
The Woodlands, TX 77380-2192
Phone
(281) 364-9880
Fax
(281) 419-2370
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14758 TX Primary

Addresses

Primary practice location

3 Grogans Park Dr
Ste: 100
The Woodlands, TX 77380-2192

Mailing address

3 Grogans Park Dr
Ste: 100
The Woodlands, TX 77380-2192
Phone (281) 364-9880

Other identifiers 1

IdentifierTypeStateIssuer
14758OtherTXSTATE LICENSE NUMBER

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

State licenses

LicenseStateTypeSpecialty
14758TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tulip Dental Care PLLC General Practice PastSince Jun 4, 2023 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386652568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 GROGANS PARK DR",
            "address_2": "STE: 100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773802192",
            "telephone_number": "281-364-9880",
            "fax_number": "281-419-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 GROGANS PARK DR",
            "address_2": "STE: 100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773802192",
            "telephone_number": "281-364-9880",
            "fax_number": "281-419-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "T.",
        "middle_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "14758",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.