Individual provider Active NPI

Jonathan David Gibbs, D.D.S.

  • General Practice Dentistry
  • Chattanooga, TN
National Provider Identifier
1386717874
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8328 Issued in TN
Practice address
7611 Hamilton Park Dr
Chattanooga, TN 37421-1125
Phone
(423) 894-9179
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 48455 CA
General Practice Dentistry 1223G0001X 8328 TN Primary

Addresses

Primary practice location

7611 Hamilton Park Dr
Chattanooga, TN 37421-1125

Mailing address

7611 Hamilton Park Dr
Chattanooga, TN 37421-1125
Phone (423) 894-9179

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
48455CAMDDentist
8328TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Affordable Dentures & Implants - Chattanooga II, P.C. General Practice CurrentSince Dec 22, 2024 Accepting new patients
Dental Associates of Cleveland PastSince Feb 9, 2020 Accepting new patients
Prasan Mohansinh Parmar DDS, Inc. Past Accepting new patients

Locations

7611 Hamilton Park Dr
Chattanooga, TN 37421
Phone (423) 894-9179

Organizations & group practices 3

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1386717874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7611 HAMILTON PARK DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211125",
            "telephone_number": "423-894-9179",
            "fax_number": "423-894-7386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7611 HAMILTON PARK DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211125",
            "telephone_number": "423-894-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48455",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "8328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.