Jerry G Caravas Jr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401006102 Issued in VA

Practice address

307 Lynnhaven Pkwy Ste 101
Virginia Beach, VA 23452-7430

Phone

(757) 471-6020

Fax

(757) 471-5205

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1417963232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 LYNNHAVEN PKWY STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527430",
            "telephone_number": "757-471-6020",
            "fax_number": "757-471-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 LYNNHAVEN PKWY STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527430",
            "telephone_number": "757-471-6020",
            "fax_number": "757-471-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARAVAS",
        "first_name": "JERRY",
        "middle_name": "G",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401006102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9178692",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.