Jalen Lawrence Gibbons, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39480 Issued in TX

Practice address

4122 S Staples St
Corpus Christi, TX 78411-2109

Phone

(361) 949-5215

NPI assigned

Apr 13, 2023

Last updated

Jun 13, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Carmel Village Family Dentistry, PLLC

  • General Practice Dentistry
  • Corpus Christi, TX
  • NPI 1326673195
  NPD

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1790471571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 N INTERSTATE 35 STE 205",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762071438",
            "telephone_number": "940-220-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 S STAPLES ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784112109",
            "telephone_number": "361-949-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "JALEN",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "39480",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Ghaleb, MD
• Yusef Ghamarian, FNP-BC, PMHNP-BC
• Salam Izdain Gharaybeh, M.D.
• Tariq Ghazal, BDS, MS, PHD, DABDPH
• Ghep Corpus Christi PLLC
• Norma Irene Gibbons
• Anthony Patrick Gibson
• Blinda Ann Gibson, MS, CCC-SLP
• Bruce A Gibson, M.D.
• Chad Gibson, PHARMD

• General Practice Dentistry in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.