NPIMap

Organization Active NPI

Michele a. Bibeau, D.D.S.

  • General Practice Dentistry
  • Prescott, AZ
National Provider Identifier
1790159853
Registry record updated Nov 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MICHELE A. BIBEAU, D.D.S.
Practice address
1058 Fair Street
Suite a
Prescott, AZ 86305
Phone
(928) 776-0606
Fax
(928) 776-0102
NPI assigned
Nov 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2015

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

Authorized official

Name
Dr. Michele A Bibeau, DDSNPI 1053517185
Title
Owner
Phone
(928) 776-0606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1058 Fair Street
Suite a
Prescott, AZ 86305

Mailing address

1058 Fair Street
Suite a
Prescott, AZ 86305
Phone (928) 776-0606

National Provider Directory

National Provider Directory

Locations

1058 Fair St
Ste A
Prescott, AZ 86305
Phone (928) 776-0606

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448841600000",
    "number": "1790159853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1058 FAIR STREET",
            "address_2": "SUITE A",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86305",
            "telephone_number": "928-776-0606",
            "fax_number": "928-776-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1058 FAIR STREET",
            "address_2": "SUITE A",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86305",
            "telephone_number": "928-776-0606",
            "fax_number": "928-776-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELE A. BIBEAU, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-30",
        "last_updated": "2015-11-30",
        "status": "A",
        "authorized_official_last_name": "BIBEAU",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-776-0606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; 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.