Organization Active NPI

Jessica Lynn Gibbs, DDS, P.C.

Doing business as Smile Glen Ellyn

  • Dental Clinic/Center
  • Glen Ellyn, IL
National Provider Identifier
1780492959
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
JESSICA LYNN GIBBS, DDS, P.C.
Doing business as
Smile Glen Ellyn
Practice address
26 N Park Blvd
Glen Ellyn, IL 60137-5712
Phone
(630) 858-8800
NPI assigned
Dec 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Authorized official

Name
Dr. Jessica Lynn Gibbs, DDS
Title
Dentist/Owner
Phone
(630) 452-1281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

26 N Park Blvd
Glen Ellyn, IL 60137-5712

Mailing address

26 N Park Blvd
Glen Ellyn, IL 60137-5712
Phone (630) 858-8800

Other names 1

  • Smile Glen Ellyn Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735603200000",
    "number": "1780492959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 N PARK BLVD",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375712",
            "telephone_number": "630-858-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 N PARK BLVD",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375712",
            "telephone_number": "630-858-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA LYNN GIBBS, DDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-20",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "630-452-1281",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Glen Ellyn",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smile Glen Ellyn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.