Gavin McNelis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61149670 Issued in WA

Practice address

20302 77TH Ave NE
Arlington, WA 98223-7462

Phone

(360) 435-2151

NPI assigned

Jul 15, 2020

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

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": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1760090831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20302 77TH AVE NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982237462",
            "telephone_number": "360-435-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20302 77TH AVE NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982237462",
            "telephone_number": "360-435-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNELIS",
        "first_name": "GAVIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-15",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61149670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Michell McIntyre, LCSW
• Pamela Kay McKeown, MSW
• April Lynn McLean
• Jered McLennan, DC
• Holly J McMillan
• Myra J McPherson, PT
• Smith Monson Meads, D.O.
• Medical Diagnostic Specialties, Inc.
• Anna Weisenburger Mellem, PA-C
• Cheryl A Meng, LICSW

• General Practice Dentistry in Arlington, WA
• Providers in Arlington, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.