Douglas Brian Gibbons III, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD1483 Issued in NM

Practice address

1101 Medical Arts Ave NE
Sandia Medical Park BLDG. # 1
Albuquerque, NM 87102-2706

Phone

(505) 842-0808

Fax

(505) 842-1165

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

State licenses

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760401830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL ARTS AVE NE",
            "address_2": "SANDIA MEDICAL PARK BLDG. # 1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022706",
            "telephone_number": "505-842-0808",
            "fax_number": "505-842-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL ARTS AVE NE",
            "address_2": "SANDIA MEDICAL PARK BLDG. # 1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022706",
            "telephone_number": "505-842-0808",
            "fax_number": "505-842-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "DOUGLAS",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD1483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giant Strides Therapy, LLC
• Carmella Giaquinto
• Heather Giarratano, RN
• James Ingram Gibb, MD
• Josie Gibb, LPCC
• Kathleen Gibbons, LISW
• Montine Gibbons Sr., SLP
• Jennifer Marie Gibbs, CNP
• Marcus Gibbs
• Lawrence Gibel, MD

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.