Maria Gabriela Tibavinsky, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

060774 Issued in NY

Practice address

1667 Lexington Ave
New York, NY 10029-4962

Phone

(212) 289-4131

NPI assigned

Dec 4, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Maria Gabriela Tibavinsky Bernal Former name

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.

• Wellspring Dental PLLC

  • Dentist
  • Brooklyn, NY
  • NPI 1295290351
  NPD (past)

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1982174744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 CHURCH ST",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108053204",
            "telephone_number": "678-548-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1667 LEXINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294962",
            "telephone_number": "212-289-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBAVINSKY",
        "first_name": "MARIA",
        "middle_name": "GABRIELA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015657",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "060774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "TIBAVINSKY BERNAL",
            "middle_name": "GABRIELA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Tian, MD
• Wenping Tian, CNM
• Yixuan Tian
• Justin Tiao, MD
• Kayla Tibaldo
• Nino Jiao Tibay, AGPCNP, NP-C
• Aryanna Lynn Tiberii
• Matthew Joseph Tiberino
• Tiberiu Salamon M.D., P.C.
• Gina Elena Tibke

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.