Jill Emily Gibson, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

10587 Issued in SC

Practice address

3929 S Highway 14
Greenville, SC 29615-6138

Phone

(423) 715-8413

NPI assigned

May 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 2, 2025 through Nov 2, 2027

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Greenville Oral Maxillofacial Surgery, P.a., a South Carolina Professi

  • Oral and Maxillofacial Surgery (Dentist)
  • Greenville, SC
  • NPI 1619008547
  NPD (past)
• Associated Oral and Maxillofacial Surgeons of Peoria, LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Peoria, IL
  • NPI 1154357291
  NPD (past)

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1437648045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 S HIGHWAY 14",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156138",
            "telephone_number": "423-715-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 S HIGHWAY 14",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156138",
            "telephone_number": "423-715-8413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Union Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381033513",
            "country_code": "US",
            "telephone_number": "423-715-8413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "JILL",
        "middle_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "10587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Gibbs, PHYSICAL THERAPIST
• Emily Gibbs
• Susanna Maria Gibbs, REGISTERED NURSE
• Gibson Psychological Services LLC
• Andrew Scott Gibson, PHD
• Katherine Gibson
• Latoya D Gibson
• Misha Kay Gibson, LISW-CP
• Patricia K. Gibson
• Tammy Kirby Gibson

• Oral and Maxillofacial Surgery (Dentist) in Greenville, SC
• Providers in Greenville, SC by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.