Individual provider Active NPI

Chris John Giblette, D.M.D

  • Dentist
  • Kirtland, NM
National Provider Identifier
1871973693
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD4287 Issued in NM
Practice address
#3 CR 6523
Kirtland, NM 87417
Phone
(505) 598-6800
NPI assigned
Jun 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DD4287 NM Primary

Addresses

Primary practice location

#3 CR 6523
Kirtland, NM 87417

Mailing address

#3 CR 6523
Kirtland, NM 87417
Phone (505) 598-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DD4287NMMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Family Dental of Kirtland, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1433548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1871973693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#3 CR 6523",
            "city": "KIRTLAND",
            "state": "NM",
            "postal_code": "87417",
            "telephone_number": "505-598-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#3 CR 6523",
            "city": "KIRTLAND",
            "state": "NM",
            "postal_code": "87417",
            "telephone_number": "505-598-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBLETTE",
        "first_name": "CHRIS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-06",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirtland, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.