Richard Lee Davis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

TN07423 Issued in TN

Practice address

611 E Main St
Waverly, TN 37185-1718

Phone

(931) 296-2804

NPI assigned

Oct 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013091768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 494",
            "city": "WAVERLY",
            "state": "TN",
            "postal_code": "371850494",
            "telephone_number": "931-296-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E MAIN ST",
            "city": "WAVERLY",
            "state": "TN",
            "postal_code": "371851718",
            "telephone_number": "931-296-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "TN07423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Darlene Clark, LPN
• Nicole A Coffman-Cole, DC
• Alexandria Lynnly Cole, APRN
• Daniel Terry Cole, D.C.
• Mary B. Davis, APN
• Amanda Deason, NP
• Dialysis Clinic Inc.
• Dickson Medical Associates, PC (DMA Pediatrics and Specialty Clinic)
• Dickson Medical Associates, PC
• Daniel Robert Dillard, DDS

• General Practice Dentistry in Waverly, TN
• Providers in Waverly, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.