Christopher Walter Gibson, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

059580-1 Issued in NY

Practice address

3630 Hill Blvd Ste 101
Jefferson Valley, NY 10535-1503

Phone

(914) 245-7100

NPI assigned

Mar 19, 2015

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

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": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1629462429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 LEXINGTON AVE APT 9H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297161",
            "telephone_number": "978-758-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 HILL BLVD STE 101",
            "city": "JEFFERSON VALLEY",
            "state": "NY",
            "postal_code": "105351503",
            "telephone_number": "914-245-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1478 Post Rd",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CT",
            "postal_code": "068245938",
            "country_code": "US",
            "telephone_number": "203-255-6851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-19",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "11815",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "059580-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Leigh Engelberg, PHARM D
• Charles M Fillebrown, DPM
• Alan Fischer, R.PH.
• William Daniel Fitzgibbon, AU.D.
• Ashley Marie Gagliardi
• Young Ho Han, MD
• Julie Cyr Harris, DMD
• Myrna Hernandez, M.D.
• Mark Robert Honig, PHD
• Hudson Valley Tongue Tied Dental PC

• Pediatric Dentistry in Jefferson Valley, NY
• Providers in Jefferson Valley, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.