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General NPI Number Information
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NPI Number | 1275741860
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Entity Type | Individual
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Provider Name | DAVID GREGORY HIEBERT D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 1816 S RANGE LINE RD STE D
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City | JOPLIN
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State | MO
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Zip | 64804-3277
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Country | US
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Telephone | 417-572-0002
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Fax |
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Provider Business Mailing Address
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Address Line | 2107 SADIE CT
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City | JOPLIN
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State | MO
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Zip | 64801-4835
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Country | US
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Telephone | 918-533-0908
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 85279
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 3972
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2014044094
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License Number State | MO
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