Provider Demographics
NPI:1003431354
Name:GIBNEY, PATRICK (DMD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
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 1:1300 AVENUE AT PORT IMPERIAL APT 735
Mailing Address - Street 2:
Mailing Address - City:WEEHAWKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07086-6971
Mailing Address - Country:US
Mailing Address - Phone:845-494-0416
Mailing Address - Fax:
Practice Address - Street 1:32B WATERVIEW BLVD
Practice Address - Street 2:
Practice Address - City:PARSIPPANY-TROY HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07054
Practice Address - Country:US
Practice Address - Phone:973-240-9451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI028367001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice