Michael Kevin Gavin, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

37420 Issued in CA

Practice address

5680 Lake Murray Blvd Ste B
La Mesa, CA 91942-1905

Phone

(858) 208-6042

NPI assigned

Aug 31, 2006

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

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1457462228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 LAKE MURRAY BLVD STE B",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421905",
            "telephone_number": "604-285-8208",
            "fax_number": "619-462-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 LAKE MURRAY BLVD STE B",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421905",
            "telephone_number": "858-208-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "MICHAEL",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "37420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "michaelgavin@earthlink.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5680 Lake Murray Blvd Ste B",
            "city": "LA Mesa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "919421905",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "michaelgavin@earthlink.net",
            "affiliation": "N",
            "address_1": "5680 Lake Murray Blvd Ste B",
            "city": "LA Mesa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "919421905",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "michaelgavin@earthlink.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5680 Lake Murray Blvd Ste B",
            "city": "LA Mesa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "919421905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Garmo
• Alexander Rawley Garretson
• Gary D Hittle PHD
• Mary K Gauert, R.P.T
• Julie Gauthier, DC
• Franklin D. Gaylis, M.D.
• Hala Jinan Gazalah-Darzi, PHARMACIST
• Wesley N Ge
• Andrew Jay Gellens, MD
• Victoria Gellis, IBCLC

• Endodontics in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.