Individual provider Active NPI

Gary Frank Cavaness Jr., D.D.S.

  • General Practice Dentistry
  • Anchorage, AK
National Provider Identifier
1376791251
Registry record updated Dec 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1379 Issued in AK
Practice address
8301 Briarwood St Ste 202
Anchorage, AK 99518-3333
Phone
(907) 349-3569
NPI assigned
Sep 3, 2008
Last updated
Dec 1, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7078714-9922 UT
General Practice Dentistry 1223G0001X 1379 AK Primary

Addresses

Primary practice location

8301 Briarwood St Ste 202
Anchorage, AK 99518-3333

Mailing address

8301 Briarwood St Ste 202
Anchorage, AK 99518-3333
Phone (907) 349-3569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150731015098 AK Order and Referring Only - DentistPractitioner - Dentist 4284948431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1379AKMDGeneral Practice Dentistry
7078714-9922UTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Smiles Dental LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1376791251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 BRIARWOOD ST STE 202",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995183333",
            "telephone_number": "907-349-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 BRIARWOOD ST STE 202",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995183333",
            "telephone_number": "907-349-3569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANESS",
        "first_name": "GARY",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "7078714-9922",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "1379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.