Clibon Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

44580 Issued in CA

Legal business name

CLIBON DENTAL CORPORATION

Practice address

15366 11TH St
Suite G
Victorville, CA 92395-3726

Phone

(760) 245-8616

NPI assigned

Feb 12, 2008

Last updated

Feb 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory Clibon, D.D.S.

Title

President

Phone

(760) 245-8616

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1790953859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15366 11TH ST",
            "address_2": "SUITE G",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953726",
            "telephone_number": "760-245-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15366 11TH ST",
            "address_2": "SUITE G",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953726",
            "telephone_number": "760-245-8616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIBON DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "CLIBON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-245-8616",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Victorville, CA
• Providers in Victorville, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.