Organization
VICKI L. TIBBS, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICKI LEE TIBBS DDS (DENTIST/PRESIDENT)
(804) 932-4537
Entity
Organization
Contact information
Practice address
2632 POCAHONTAS TRAIL, QUINTON, VA 23141
(804) 932-4537
(804) 932-4888
Mailing address
1612 HUGUENOT RD, MIDLOTHIAN, VA 23113
(804) 794-9789
(804) 419-1059
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
—
78-0261-7
—
VA
Enumeration date
08/08/2006
Last updated
08/25/2021
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