Provider Demographics
NPI:1699109942
Name:GIBNEY, JAMES WILLIAMS (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAMS
Last Name:GIBNEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 PARKER AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-4027
Mailing Address - Country:US
Mailing Address - Phone:352-686-4223
Mailing Address - Fax:352-686-6827
Practice Address - Street 1:1433 PARKER AVE
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-4027
Practice Address - Country:US
Practice Address - Phone:352-686-4223
Practice Address - Fax:352-686-6827
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN105001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice