Active NPI
Jan Marie Gibson
- Dental Hygienist
- Fort Bliss, TX
National Provider Identifier
1417911496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 6445
- Practice address
- BLDG 128 Chaffee Rd, US Army Dental Activity
Attn: Dentac Headquearters
Fort Bliss, TX 79916 - Phone
- (915) 742-6001
- NPI assigned
- Apr 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 6445 | WA | Primary |
Addresses
Primary practice location
BLDG 128 Chaffee Rd, US Army Dental Activity
Attn: Dentac Headquearters
Fort Bliss, TX 79916
Mailing address
215 Sheridan Rd
El Paso, TX 79906-3803
Phone (253) 283-9106
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6445 | WA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466035200000",
"number": "1417911496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 SHERIDAN RD",
"city": "EL PASO",
"state": "TX",
"postal_code": "799063803",
"telephone_number": "253-283-9106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BLDG 128 CHAFFEE RD, US ARMY DENTAL ACTIVITY",
"address_2": "ATTN: DENTAC HEADQUEARTERS",
"city": "FORT BLISS",
"state": "TX",
"postal_code": "79916",
"telephone_number": "915-742-6001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "JAN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-14",
"last_updated": "2016-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WA",
"license": "6445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bliss, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.