Healthcare Provider Details

I. General information

NPI: 1336915529
Provider Name (Legal Business Name): GUNNAR ROBERT VELIKANJE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 2ND ST
CHENEY WA
99004-1910
US

IV. Provider business mailing address

731 N IRON BRIDGE WAY
SPOKANE WA
99202-4926
US

V. Phone/Fax

Practice location:
  • Phone: 509-444-8200
  • Fax: 509-434-0392
Mailing address:
  • Phone: 509-444-8888
  • Fax: 509-444-7806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDENT.DE.70134057
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: