NPIMap

Individual provider Active NPI

Joanne S Davis, D.M.D.

  • General Practice Dentistry
  • Stockbridge, GA
National Provider Identifier
1073779567
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
012356 Issued in GA
Practice address
1100 Eagles Landing Pkwy
Suite a
Stockbridge, GA 30281-7271
Phone
(770) 389-0389
Fax
(770) 389-8644
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 012356 GA Primary

Addresses

Primary practice location

1100 Eagles Landing Pkwy
Suite a
Stockbridge, GA 30281-7271

Mailing address

1100 Eagles Landing Pkwy
Suite a
Stockbridge, GA 30281-7271
Phone (770) 389-0389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
012356GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Kurtis and Joanne Davis, P.C. General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1073779567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 EAGLES LANDING PKWY",
            "address_2": "SUITE A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817271",
            "telephone_number": "770-389-0389",
            "fax_number": "770-389-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 EAGLES LANDING PKWY",
            "address_2": "SUITE A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817271",
            "telephone_number": "770-389-0389",
            "fax_number": "770-389-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOANNE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "012356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.