Mark L Davis DDS, a Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60661 Issued in CA

Legal business name

MARK L DAVIS DDS, A DENTAL CORPORATION

Practice address

268 S Halcyon
Arroyo Grande, CA 93420

Phone

(805) 489-8444

NPI assigned

Oct 4, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Mark Lawrence Davis, DDS

Title

Pres/Owner/Dentist

Phone

(805) 328-0459

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1380844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380844800000",
    "number": "1104253178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 S HALCYON",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "93420",
            "telephone_number": "805-489-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 S HALCYON",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "93420",
            "telephone_number": "805-489-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK L DAVIS DDS, A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-04",
        "last_updated": "2013-10-04",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRES/OWNER/DENTIST",
        "authorized_official_telephone_number": "805-328-0459",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reshma Mahmood, MD
• Lori Mallory, RDH
• David Michael Malouf, OD
• Paul Malouf, LMFT
• Marisol Mariscal, LMFT
• David M. Marquis, D.C.
• Andrew Ryan Martin, PT, DPT
• Travis Colby Martin, DPT
• Lisa Martinez
• Mary & David Medical Equipment Service & Repairs

• General Practice Dentistry in Arroyo Grande, CA
• Providers in Arroyo Grande, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; 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.