Individual provider · Type 1 NPI

Kevin Tan Bibera, DDS

Student in an Organized Health Care Education/Training Program · Memphis, TN

NPI number 1770196024 Active

Practice location

875 Union Avenue Suite C211
Memphis, TN 38163-8781

Call (901) 448-7180 Map

Mailing address

1854 Claire Ct
Concord, CA 94519-2359

Other practice locations

  • 20406 Brian Way # 2, Tehachapi, CA 93561-8781 · (661) 822-6706

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry 1223G0001X105025 (CA)
Student in an Organized Health Care Education/Training Program Primary 390200000X105025 (CA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1770196024

Kevin Tan Bibera, DDS's National Provider Identifier is 1770196024, issued on Aug 26, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Memphis, TN. The record was last updated on Apr 27, 2022.