Lionel A Gibson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019028820 Issued in IL

Practice address

350 N Clark St
Suite 600
Chicago, IL 60654-4712

Phone

(312) 274-4524

NPI assigned

Jul 25, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

State licenses

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442188800000",
    "number": "1417235524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLARK ST",
            "address_2": "SUITE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544712",
            "telephone_number": "312-274-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N CLARK ST",
            "address_2": "SUITE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544712",
            "telephone_number": "312-274-4524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "LIONEL",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-25",
        "last_updated": "2015-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014322",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028820",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "5864 C1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Nicole Gibson
• Hollis Hunter Gibson, D.D.S.
• Jennifer L Gibson, PSYD
• Joy C Gibson, APRN, CNP
• Julia Gibson, MS, RD, LDN
• Lydia Gibson
• Meghan Gibson, LAC.
• Molly Gibson
• Roland M Gibson Jr., D.D.S
• Sandy Yevette Gibson, D.O.

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; 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.