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Individual
DR. KIMBERLY SMITH BIBBINS
Active
Individual
DR. KIMBERLY SMITH BIBBINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
28757
TX
1223G0001X
General Practice Dentistry
28757
TX
1223G0001X
General Practice Dentistry
Primary
6413
LA
1223G0001X
General Practice Dentistry
9458
TN
390200000X
Student in an Organized Health Care Education/Training Program
S-711
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00HE78
MEDICARE PART B - GROUP
TX
05
—
126826002
—
TX
05
—
2890573
—
LA
01
—
451821
MEDICARE PART A - GROUP
TX
01
—
5B803
MEDICARE PART B - GROUP
LA
Enumeration date
06/22/2011
Last updated
02/22/2019
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