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Individual
VICKI LEE TIBBS
Active
Individual
VICKI LEE TIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6227
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
461774
ANTHEM
VA
01
—
620361
UCCI
VA
05
—
78026107
—
VA
Enumeration date
01/28/2008
Last updated
01/28/2008
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