NPIMap

Organization Active NPI

Maurice Davis DDS PA

  • General Practice Dentistry
  • Weldon, NC
National Provider Identifier
1093886954
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4627 Issued in NC
Legal business name
MAURICE DAVIS DDS PA
Practice address
100 Elm St
Weldon, NC 27890
Phone
(252) 536-3105
Fax
(252) 536-4607
NPI assigned
Nov 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Anzell Maurice Davis, DDSNPI 1740455815
Title
Owner
Phone
(252) 536-3105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 4627 NC Primary

Addresses

Primary practice location

100 Elm St
Weldon, NC 27890

Mailing address

PO Box 805
100 Elm St
Weldon, NC 27890
Phone (252) 536-3105

Other identifiers 1

IdentifierTypeStateIssuer
8992022MedicaidNC

National Provider Directory

National Provider Directory

Locations

100 Elm St
Weldon, NC 27890
Phone (252) 536-3105

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093886954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 805",
            "address_2": "100 ELM ST",
            "city": "WELDON",
            "state": "NC",
            "postal_code": "27890",
            "telephone_number": "252-536-3105",
            "fax_number": "252-536-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ELM ST",
            "city": "WELDON",
            "state": "NC",
            "postal_code": "27890",
            "telephone_number": "252-536-3105",
            "fax_number": "252-536-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAURICE DAVIS DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ANZELL",
        "authorized_official_middle_name": "MAURICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-536-3105",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "4627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8992022",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weldon, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.