Gavin Convey, B. DENT. SC.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DE60717233 Issued in WA

Practice address

11800 NE 128TH St Ste 540
Kirkland, WA 98034-7208

Phone

(425) 326-7046

NPI assigned

Aug 14, 2008

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Washington Endodontics LLC

  • Endodontics
  • Kirkland, WA
  • NPI 1154260347
  NPD Authorized official

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144476813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8315 NE 120TH ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980345831",
            "telephone_number": "425-326-7046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 NE 128TH ST STE 540",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347208",
            "telephone_number": "425-326-7046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3710 168th St NE",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "WA",
            "postal_code": "982238461",
            "country_code": "US",
            "telephone_number": "360-651-9394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONVEY",
        "first_name": "GAVIN",
        "name_prefix": "Dr.",
        "credential": "B. DENT. SC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "25099",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE60717233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Patrick Connor, M.D.
• Christopher Nicolaus Conrad, LMT
• Consolidated Dental LLC
• Kristi E Content
• Anadalay Contreras Paez
• Ryan Sean Coogan, D.C.
• Madison Rose Cook
• Ashley Cooke
• Gwendolynn Anne Coombs-Miller
• Ashley Nicole Cooper, ND

• Endodontics in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Endodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.