Thomas E. Kavanagh, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17098 Issued in OH

Practice address

1417 Marlowe Ave
Lakewood, OH 44107-4318

Phone

(216) 221-7500

Fax

(216) 221-2430

NPI assigned

Mar 24, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Thomas E Kavanagh DDS Inc

  • General Practice Dentistry
  • Lakewood, OH
  • NPI 1265147268
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093832917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 MARLOWE AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074318",
            "telephone_number": "216-221-7500",
            "fax_number": "216-221-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 MARLOWE AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074318",
            "telephone_number": "216-221-7500",
            "fax_number": "216-221-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAGH",
        "first_name": "THOMAS",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "17098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0499929",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Celia Joyce, LSW
• Julie Branch Counseling
• Jessica Marie Jurcak, MS, MPH, RD LD
• Bradley Justice, LISW
• Mohamad Kalash, MD
• Samantha Kavander, RDN
• Kazsmer Counseling Service Inc
• Karen Ann Kazsmer, M.A., LPCC
• Sarah Rose Keating, MD
• Sky Marie Kelley

• General Practice Dentistry in Lakewood, OH
• Providers in Lakewood, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.