Individual provider Active NPI

Kristen Kari Gibson, DDS

  • General Practice Dentistry
  • Mercer Island, WA
National Provider Identifier
1891723573
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6855 Issued in WA
Practice address
7419 SE 24TH St
Mercer Island, WA 98040-2326
Phone
(206) 232-2623
Fax
(206) 232-9892
NPI assigned
Jun 29, 2006
Sex
Female
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
General Practice Dentistry 1223G0001X 6855 WA Primary

Addresses

Primary practice location

7419 SE 24TH St
Mercer Island, WA 98040-2326

Mailing address

7419 SE 24TH St
Mercer Island, WA 98040-2326
Phone (206) 232-2623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160125002038 WA Order and Referring Only - DentistPractitioner - Dentist 1951604990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6855WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis and Gibson, LLP Past Accepting new patients
Gibson and Felker Past Accepting new patients

Organizations & group practices 2

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891723573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7419 SE 24TH ST",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402326",
            "telephone_number": "206-232-2623",
            "fax_number": "206-232-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7419 SE 24TH ST",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402326",
            "telephone_number": "206-232-2623",
            "fax_number": "206-232-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "KRISTEN",
        "middle_name": "KARI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mercer Island, WA

Sources for this page

Verify at the official NPI Registry.