Tracy L. Davidian, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

200001373637 Issued in NC

Practice address

3917 Sunset Ridge Rd
Raleigh, NC 27607-6415

Phone

(919) 783-9686

Fax

(919) 783-0371

NPI assigned

Apr 10, 2007

Sex

Female

Sole proprietor

No

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

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.

• Tracy L Davidian DDS PA

  • Customized Equipment (DME)
  • Raleigh, NC
  • NPI 1053779538
  NPD (past) Authorized official
• Davidian & Associates

  • General Practice Dentistry
  • Raleigh, NC
  • NPI 1043438872
  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083737290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 SUNSET RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 SUNSET RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076415",
            "telephone_number": "919-783-9686",
            "fax_number": "919-783-0371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDIAN",
        "first_name": "TRACY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "200001373637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa M. David, PA-C
• Davidian & Associates
• Daniel K. Davidian, DDS
• Melissa Church Davidian, DDS
• Davidian, PLLC
• Anna Davidow
• Hatima N Davidson, PHARMD
• Jason Howard Davidson, DC, CSCS
• Jessica Davidson, MPH, RD, LDN.
• Kyle Matthew Davidson, DPT

• General Practice Dentistry in Raleigh, NC
• Providers in Raleigh, NC by specialty
• General Practice Dentistry in North Carolina

• 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.