Active NPI
Lisa A Davis
- Dentist
- Atlanta, GA
National Provider Identifier
1124481585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN012325
- Practice address
- 300 W Wieuca Rd NE
Building 2 Suite 210
Atlanta, GA 30342-3352 - Phone
- (404) 252-4220
- NPI assigned
- Apr 3, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | DN012325 | GA | Primary |
Addresses
Primary practice location
300 W Wieuca Rd NE
Building 2 Suite 210
Atlanta, GA 30342-3352
Mailing address
300 W Wieuca Rd NE
Building 2 Suite 210
Atlanta, GA 30342-3352
Phone (404) 252-4220
Other names 1
- Lisa A Davis
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN012325 | GA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459641600000",
"number": "1124481585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W WIEUCA RD NE",
"address_2": "BUILDING 2 SUITE 210",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303423352",
"telephone_number": "404-252-4220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W WIEUCA RD NE",
"address_2": "BUILDING 2 SUITE 210",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303423352",
"telephone_number": "404-252-4220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LISA",
"middle_name": "A",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-03",
"last_updated": "2016-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN012325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "DAVIS",
"middle_name": "A",
"credential": "D.D.S.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.