Kevin Tan Bibera, DDS is a
Student In An Organized Health Care Education/training Program based in Memphis, Tennessee. Kevin Tan Bibera is licensed to practice in California (license number 105025) and his current practice location is
875 Union Avenue Suite C211, Memphis, Tennessee. He can be reached at his office (for appointments etc.) via phone at
(901) 448-7180.
NPI number for Kevin Tan Bibera is 1770196024 and his current mailing address is 1854 Claire Ct, Concord, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1770196024.
Healthcare Provider's Profile
| Full Name | Kevin Tan Bibera |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 875 Union Avenue Suite C211, Memphis, Tennessee |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1770196024
- Provider Enumeration Date: 08/26/2020
- Last Update Date: 04/27/2022
Medical Identifiers
Medical identifiers for Kevin Tan Bibera such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770196024 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 105025 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | 105025 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kevin Tan Bibera is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kevin Tan Bibera, DDS
1854 Claire Ct,
Concord, CA 94519-2359
Ph: (424) 325-9270 | Kevin Tan Bibera, DDS
875 Union Avenue Suite C211,
Memphis, TN 38163-8781
Ph: (901) 448-7180 |
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