Individual provider Active NPI

Martha S Bibb, DMD

  • General Practice Dentistry
  • Portland, OR
National Provider Identifier
1992866859
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D6153 Issued in OR
Practice address
833 SW 11TH Ave
Suite 700
Portland, OR 97205
Phone
(503) 222-9222
Fax
(503) 222-9870
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 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 D6153 OR Primary

Addresses

Primary practice location

833 SW 11TH Ave
Suite 700
Portland, OR 97205

Mailing address

833 SW 11TH Ave
Suite 700
Portland, OR 97205
Phone (503) 222-9222

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
D6153ORMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187222400000",
    "number": "1992866859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 SW 11TH AVE",
            "address_2": "SUITE 700",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-222-9222",
            "fax_number": "503-222-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SW 11TH AVE",
            "address_2": "SUITE 700",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-222-9222",
            "fax_number": "503-222-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBB",
        "first_name": "MARTHA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.

Verify at the official NPI Registry.