Active NPI
Gianfranco Tiberia, DDS
- Dentist
- Harper Woods, MI
National Provider Identifier
1962407064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 17767
- Practice address
- 18000 Vernier Rd
Harper Woods, MI 48225-1046 - Phone
- (313) 521-2070
- NPI assigned
- Jun 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 17767 | MI | Primary |
Addresses
Primary practice location
18000 Vernier Rd
Harper Woods, MI 48225-1046
Mailing address
2550 Derby Rd
Birmingham, MI 48009-7535
Phone (248) 816-0850
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4274738 | Medicaid | MI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17767 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962407064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2550 DERBY RD",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480097535",
"telephone_number": "248-816-0850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18000 VERNIER RD",
"city": "HARPER WOODS",
"state": "MI",
"postal_code": "482251046",
"telephone_number": "313-521-2070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIBERIA",
"first_name": "GIANFRANCO",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "17767",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4274738",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harper Woods, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.