Active NPI
John B Gilbreth, D.D.S M.S.
- Endodontics
- Rio Rancho, NM
National Provider Identifier
1790097160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DD3973
- Practice address
- 4111 Barbara Loop SE
Suite B
Rio Rancho, NM 87124-1068 - Phone
- (505) 903-6916
- Fax
- (505) 903-7188
- NPI assigned
- Jul 13, 2010
- Last updated
- Jan 9, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DD3973 | NM | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
4111 Barbara Loop SE
Suite B
Rio Rancho, NM 87124-1068
Mailing address
4111 Barbara Loop SE
Suite B
Rio Rancho, NM 87124-1068
Phone (505) 903-6916
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Aug 5, 2015 through Aug 5, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DD3973 | NM | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gilbreth Group LLC | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389225600000",
"number": "1790097160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4111 BARBARA LOOP SE",
"address_2": "SUITE B",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871241068",
"telephone_number": "505-903-6916",
"fax_number": "505-903-7188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4111 BARBARA LOOP SE",
"address_2": "SUITE B",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871241068",
"telephone_number": "505-903-6916",
"fax_number": "505-903-7188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILBRETH",
"first_name": "JOHN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "D.D.S M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-13",
"last_updated": "2014-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NM",
"license": "DD3973",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.