Randall J Davis, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02486000 Issued in NJ

Practice address

30 Plaza 9
Manalapan, NJ 07726-3010

Phone

(732) 303-0900

NPI assigned

Nov 29, 2011

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 NJ

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Davis Center for Advanced Dentistry

  • Dentist
  • Manalapan, NJ
  • NPI 1790575983
  NPD (past)

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1023385408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PLAZA 9",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "07726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PLAZA 9",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263010",
            "telephone_number": "732-303-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RANDALL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-29",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02486000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonia Dasilva, BCBA, LSW
• David S. Davidson, PA-C
• Davis Center for Advanced Dentistry
• Allen Joseph Davis
• Paige M Davis, DMD
• Tara D Davis, LSW
• DB Orthopedic Physical Therapy of Manalapan, LLC
• Laura De Cillis, LSW
• Jessica Ann Deak, PT, DPT
• James Peter Decesare, FNP

• Dentist in Manalapan, NJ
• Providers in Manalapan, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.