Active NPI
Jeff Brigham Davis, D.M.D.
- Dentist
- Phoenix, AZ
National Provider Identifier
1114154648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D7756
- Practice address
- 34640 N North Valley Pkwy
Suite 104
Phoenix, AZ 85086-3247 - Phone
- (623) 879-9503
- NPI assigned
- Jun 10, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D7756 | AZ | Primary |
Addresses
Primary practice location
34640 N North Valley Pkwy
Suite 104
Phoenix, AZ 85086-3247
Mailing address
34640 N North Valley Pkwy
Suite 104
Phoenix, AZ 85086-3247
Phone (623) 879-9503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150807015513 | AZ | Order and Referring Only - Dentist | 2163736802 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7756 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tramonto Dental Group, LLP | 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.
-
- General Practice Dentistry
- Phoenix, AZ
- NPI 1164693669
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244592000000",
"number": "1114154648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34640 N NORTH VALLEY PKWY",
"address_2": "SUITE 104",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850863247",
"telephone_number": "623-879-9503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34640 N NORTH VALLEY PKWY",
"address_2": "SUITE 104",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850863247",
"telephone_number": "623-879-9503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JEFF",
"middle_name": "BRIGHAM",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-10",
"last_updated": "2009-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D7756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; 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.