Active NPI
Amy Michelle Gavin, DMD
- General Practice Dentistry
- Goodyear, AZ
National Provider Identifier
1437583846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D008730
- Practice address
- 781 S Cotton LN
Suite 100
Goodyear, AZ 85338-4643 - Phone
- (623) 882-3636
- NPI assigned
- Aug 21, 2013
- Last updated
- Aug 21, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D008730 | AZ | Primary |
Addresses
Primary practice location
781 S Cotton LN
Suite 100
Goodyear, AZ 85338-4643
Mailing address
781 S Cotton LN
Suite 100
Goodyear, AZ 85338-4643
Phone (623) 882-3636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D008730 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goodyear Smiles, LLP | General Practice | 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": "1377043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377043200000",
"number": "1437583846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "781 S COTTON LN",
"address_2": "SUITE 100",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853384643",
"telephone_number": "623-882-3636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "781 S COTTON LN",
"address_2": "SUITE 100",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853384643",
"telephone_number": "623-882-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAVIN",
"first_name": "AMY",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-21",
"last_updated": "2013-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D008730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.