Individual provider Active NPI

Tanya Marie Gibson, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Kansas City, MO
National Provider Identifier
1861796526
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
26D0652227 Issued in MO
Practice address
650 E 25TH St
Kansas City, MO 64108-2716
Phone
(816) 235-2133
Fax
(816) 235-5473
NPI assigned
Jan 10, 2011
Last updated
Apr 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 44D2016339 TN
Oral and Maxillofacial Pathology Dentistry 1223P0106X 26D0652227 MO Primary

Addresses

Primary practice location

650 E 25TH St
Kansas City, MO 64108-2716

Mailing address

650 E 25TH St FL 3
Kansas City, MO 64108-2716
Phone (816) 235-2133

Other identifiers 2

IdentifierTypeStateIssuer
2012015348OtherMOMO DEPT OF COMMERCE AND INS DIVISION OF PROFESSION REGISTRATION MO DENTAL BOARD
8615OtherTXMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20260323002553 MO Order and Referring Only - Oral and Maxillofacial PathologyPractitioner - Oral and Maxillofacial Pathology 2466636790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8615TNMDClinical Social Worker
26D0652227MOMDOral and Maxillofacial Pathology Dentist
44D2016339TNMDClinical Medical Laboratory

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1861796526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 E 25TH ST FL 3",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082716",
            "telephone_number": "816-235-2133",
            "fax_number": "816-235-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E 25TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082716",
            "telephone_number": "816-235-2133",
            "fax_number": "816-235-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "TANYA",
        "middle_name": "MARIE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TN",
            "license": "44D2016339",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MO",
            "license": "26D0652227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO DEPT OF COMMERCE AND INS DIVISION OF PROFESSION REGISTRATION MO DENTAL BOARD",
            "identifier": "2012015348",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "8615",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.