Timothy Curtis Gibson Jr., DDS, MS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

10619 Issued in SC

Practice address

617 Myers Rd Ste B
Summerville, SC 29486-8902

Phone

(843) 647-6052

NPI assigned

May 31, 2019

Last updated

Feb 21, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bloom Endo, LLC

  dba Bloom Endodontics

  • Endodontics
  • Summerville, SC
  • NPI 1679342042
  NPD Authorized official

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1588222939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 MYERS RD STE B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294868902",
            "telephone_number": "843-647-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 MYERS RD STE B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294868902",
            "telephone_number": "843-647-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "TIMOTHY",
        "middle_name": "CURTIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-31",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11392",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "SC",
            "license": "10619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn J Gershkowitz, APRN
• Shauna T Gerstner, DDS
• Paige S. Gibbons, RPH
• Brooke Benson Gibbs, M.D.
• Anna Flores Gibson, LPC
• Christina Nicole Gilbert
• Pete Gill
• Latifah A Gilliard, HOME HEALTH PROVIDER
• Alexandra Kay Girard
• Ronnie M Givens II, MD

• Endodontics in Summerville, SC
• Providers in Summerville, SC by specialty
• Endodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.