Brian Alexander Gibson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DB-2023-0163 Issued in NM

Practice address

708 E 20TH St
Farmington, NM 87401-4205

Phone

(505) 327-6155

NPI assigned

Jul 3, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Esthetic Dental Group LLC

  • Dentist
  • Farmington, NM
  • NPI 1699981324
  NPD (past)

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1871270546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4231 CARDON DR",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874019284",
            "telephone_number": "505-515-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 E 20TH ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874014205",
            "telephone_number": "505-327-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "BRIAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DB-2023-0163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee Lucia Georgina
• Geps Physician Group of New Mexico, PC
• Matthew R Geter
• Dewey I Getz, DDS MSD PC
• Dwayne L Gibbs, M.D.
• Gifted Hands Surgical Assisting LLC
• Clarissa Gilbert, FCNP
• Susan Gilbert, NP
• Blair Gordon Gill, M.D.
• Sudhakar Virendra Girotra

• Dentist in Farmington, NM
• Providers in Farmington, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.