Jonathan Mark Davis, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

MA15357 Issued in MA

Practice address

1410 Highland Ave.
#203
Needham, MA 02492

Phone

(781) 444-2669

NPI assigned

Jun 14, 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

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

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

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023051257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 HIGHLAND AVE.",
            "address_2": "#203",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "02492",
            "telephone_number": "781-444-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 HIGHLAND AVE.",
            "address_2": "#203",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "02492",
            "telephone_number": "781-444-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JONATHAN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "MA15357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toan Minh Dao, BS
• Julie Marie Dateo, N.P.
• Laura Davide, LCSW
• Daphne Martha Davidson, LICSW
• Susan Hronsky Davidson, PHD
• Michael J Davis
• Jill M Day, NP
• Ddmdmd Dental Assoc
• Samuel De Melo
• Sara De Pons, LICSW

• General Practice Dentistry in Needham, MA
• Providers in Needham, MA by specialty
• General Practice Dentistry in Massachusetts

• 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.