Jeremiah C. Davis, DDS, MBA

Primary specialty

DentistTaxonomy code 122300000X

License

9774 Issued in NC

Practice address

6402 Yadkin Road
Fayetteville, NC 28303

Phone

(910) 864-4646

Fax

(910) 864-6271

NPI assigned

Jun 6, 2014

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 NC

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

Credentials

Master of Business Administration

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.

• David J Harsant DDS PA

  • General Practice Dentistry
  • Fayetteville, NC
  • NPI 1659490282
  NPD (past)

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1033522198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7151 O'KELLY ROAD (BOX 318)",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27519",
            "telephone_number": "910-864-4646",
            "fax_number": "910-864-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6402 YADKIN ROAD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28303",
            "telephone_number": "910-864-4646",
            "fax_number": "910-864-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JEREMIAH",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "DDS, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-06",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "9774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanna Davis, ATC
• Jasmine Davis, MSW, LCSWA
• Jeffrey Dean Davis, DO
• Jennifer Davis, LMFT-A
• Jennifer Kinlaw Davis, MSCCC-SLP
• Latoya F Davis, LCSWA
• Latundra Davis, NP
• Lauren Elaine Davis, MD
• Leesa Davis, CRNA
• Lynette Gray Davis, LCMHC

• Dentist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.