Tracy L Davidian DDS PA

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

7149 Issued in NC

Legal business name

TRACY L DAVIDIAN DDS PA

Practice address

5904 Six Forks Rd
Suite 225
Raleigh, NC 27609-3838

Phone

(919) 782-9955

NPI assigned

Jan 29, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tracy L Davidian, DDSNPI 1083737290

Title

Dentist/Owner

Phone

(919) 782-9955

Specialties & licenses 1

Addresses

Other names 1

• Physiologic Aesthetics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy L. Davidian, DDS

  • General Practice Dentistry
  • Raleigh, NC
  • NPI 1083737290
  NPD (past) Authorized official

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454025600000",
    "number": "1053779538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5904 SIX FORKS RD",
            "address_2": "SUITE 225",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276093838",
            "telephone_number": "919-782-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5904 SIX FORKS RD",
            "address_2": "SUITE 225",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276093838",
            "telephone_number": "919-782-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY L DAVIDIAN DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-29",
        "last_updated": "2016-01-29",
        "status": "A",
        "authorized_official_last_name": "DAVIDIAN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "919-782-9955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NC",
            "license": "7149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physiologic Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacqueline Sarah Toye, DPT
• Toyin Abimbola DDS PLLC
• Emmie Mackenzie Costen Tozier, MS, CF-SLP
• Brian Gerard Trabulsi, MPT; ATC
• Jennifer Marie Trabulsi, M.S. CCC-SLP
• Ashley Tracy, WHNP
• Gene Velitario Tracy, AGACNP
• Katherine Menk Trahan, M.D.
• Derrek Trail
• Trailfinder Kid Therapies, PLLC

• Customized Equipment (DME) in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Customized Equipment (DME) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.