Active NPI
Melissa Paige Gibson, DDS, MSD
- Pediatric Dentistry
- Ocala, FL
National Provider Identifier
1689676025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 0401411741
- Practice address
- 5465 NE 1St LN
Ocala, FL 34470-3418 - Phone
- (917) 224-4968
- NPI assigned
- Aug 15, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401411741 | VA | |
| General Practice Dentistry | 1223G0001X | 050886-1 | NY | |
| Pediatric Dentistry | 1223P0221X | 0401411741 | VA | Primary |
Addresses
Primary practice location
5465 NE 1St LN
Ocala, FL 34470-3418
Mailing address
519 W Jubal Early Dr Ste 101
Winchester, VA 22601-6517
Phone (540) 628-8533
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 |
|---|---|---|---|
| 0401411741 | VA | MD | Dentist |
| 050886-1 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523491200000",
"number": "1689676025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "519 W JUBAL EARLY DR STE 101",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226016517",
"telephone_number": "540-628-8533",
"fax_number": "540-750-4042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5465 NE 1ST LN",
"city": "OCALA",
"state": "FL",
"postal_code": "344703418",
"telephone_number": "917-224-4968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "MELISSA",
"middle_name": "PAIGE",
"name_prefix": "Dr.",
"credential": "DDS, MSD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-08-15",
"last_updated": "2018-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401411741",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "050886-1",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "VA",
"license": "0401411741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ocala, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.