Individual provider Active NPI

D Ray Gifford, DDS

  • Dentist
  • Lubbock, TX
National Provider Identifier
1841496791
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
23342 Issued in TX
Practice address
1318 Broadway St
Lubbock, TX 79401-3206
Phone
(806) 765-2611
NPI assigned
Jun 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 23342 TX Primary

Addresses

Primary practice location

1318 Broadway St
Lubbock, TX 79401-3206

Mailing address

1313 Broadway St
Suite 5
Lubbock, TX 79401-3277
Phone (806) 765-2611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190624000650 AZ Order and Referring Only - DentistPractitioner - Dentist 6103150263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841496791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 BROADWAY ST",
            "address_2": "SUITE 5",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794013277",
            "telephone_number": "806-765-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 BROADWAY ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794013206",
            "telephone_number": "806-765-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIFFORD",
        "first_name": "D",
        "middle_name": "RAY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "23342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.