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NPI Code Detail

MEDICARE: DR. REBECCA GAVIN DDS

MEDICARE:  DR. REBECCA  GAVIN  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry30.026792OH
2122300000XDentist11080KY

General Provider Information

NPI Number : 1912645383
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REBECCA GAVIN DDS
Provider Business Mailing Address
First Line : 725 ALEXANDRIA PIKE STE 100
Second Line :
City : FORT THOMAS
State : KY
Zip : 41075-2169
Country : US
Telephone Number : 859-781-0221
Fax Number :
Provider Business Practice Location Address
First Line : 725 ALEXANDRIA PIKE STE 100
Second Line :
City : FORT THOMAS
State : KY
Zip : 41075-2169
Country : US
Telephone Number : 859-781-0221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2022
Last Update Date : 03/11/2024

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Directions to “ DR. REBECCA GAVIN DDS” Practice Location

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