Dale Lawrence Giebink, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN-9696 Issued in CO

Practice address

1631 Wetzel Avenue, BLDG 815
US Army Dental Activity
Fort Carson, CO 80913

Phone

(719) 526-5537

Fax

(719) 526-5551

NPI assigned

Dec 29, 2005

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1629055850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 WETZEL AVENUE, BLDG 815",
            "address_2": "US ARMY DENTAL ACTIVITY",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "80913",
            "telephone_number": "719-526-5537",
            "fax_number": "719-526-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 WETZEL AVENUE, BLDG 815",
            "address_2": "US ARMY DENTAL ACTIVITY",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "80913",
            "telephone_number": "719-526-5537",
            "fax_number": "719-526-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIEBINK",
        "first_name": "DALE",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "14053",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN-9696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gale L Gerken, RPH
• Courtney Getchell, MD
• Heather Dawn Ghent, RN1785262
• Yolanda S Giaquinto, RDH
• Raquel Danette Gibson-Ford, LCSW
• Ryan Gifford-Hollingsworth, DO
• Andrew Robert Gilbert, M.D.
• Kelly Hannan Giraud, PA
• Ethan Christopher Glock
• Frank Joseph Godshall, PH.D.

• General Practice Dentistry in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.