Timothy Daniel Gibson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009564A Issued in IN

Practice address

1713 E 10TH St Ste a
Jeffersonville, IN 47130-7100

Phone

(812) 283-3539

NPI assigned

Feb 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396889515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 E 10TH ST STE A",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471307100",
            "telephone_number": "812-283-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 E 10TH ST STE A",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471307100",
            "telephone_number": "812-283-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "TIMOTHY",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009564A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Gibo
• Alycia Gibson, PMHNP
• Eric Gibson, RBT
• Rachel Gibson, DPT
• Steven G Gibson, MD
• Heavenly Star Gloria Gilbert, LMHCA
• Rebecca Ann Gilberts, LCSW
• Michael Andrew Goedde
• Julie Goin, MS, CADC
• Isaiah Lamarkis Goins, BA, RBT

• General Practice Dentistry in Jeffersonville, IN
• Providers in Jeffersonville, IN by specialty
• General Practice Dentistry in Indiana

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.