Sean P Avera, D.D.S., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

46165 Issued in CA

Practice address

3113 Professional Dr
Suite 5
Auburn, CA 95603-2459

Phone

(530) 885-0953

Fax

(530) 885-2980

NPI assigned

Aug 11, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 6, 2018 through Mar 6, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Sean P. Avera D.D.S., Inc.

  • Periodontics
  • Auburn, CA
  • NPI 1023221488
  NPD (past) Authorized official
• Sean P Avera, DDS Inc

  • Public Health Dentistry
  • Auburn, CA
  • NPI 1750179289
  NPD (past)

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1245519974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 PROFESSIONAL DR",
            "address_2": "SUITE 5",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032459",
            "telephone_number": "530-885-0953",
            "fax_number": "530-885-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 PROFESSIONAL DR",
            "address_2": "SUITE 5",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032459",
            "telephone_number": "530-885-0953",
            "fax_number": "530-885-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERA",
        "first_name": "SEAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "46165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Auburn Pain Rehabilitation Medical Ctr.
• Auburn Surgical Center LP
• Auburn Union Elementary School District
• Narine Avagyan
• Julie Ann Avendano
• Guadalupe Avila-Kirwan, MD
• Frank Avila
• Lyn Swe Aye, M.D.
• Gwen Hyatt Ayliffe, M.S.
• John Frank Ayres, PHARMD

• Periodontics in Auburn, CA
• Providers in Auburn, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.