Jordan D Davis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8342541 Issued in UT

Practice address

469 Medical Dr Ste 200
Bountiful, UT 84010-8922

Phone

(801) 292-5812

NPI assigned

Jul 2, 2011

Last updated

Sep 12, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 UT

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

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

{
    "created_epoch": "1309564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1144517749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 MEDICAL DR STE 200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108922",
            "telephone_number": "801-292-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 MEDICAL DR STE 200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108922",
            "telephone_number": "801-292-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JORDAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-02",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "8342541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Davis County General Surgery, P.L.L.C
• Davis County Midwives LLC
• Alisa Porter Davis, NP
• Avri Leigh Davis
• Deverey Starkey Davis
• Ryan Gerald Davis, APRN, FNP-C
• Bessann Dawson, MD
• Todd Daynes, MD
• David M Dayton, P.T.
• DDMS of Utah No.2 (North Side Center)

• General Practice Dentistry in Bountiful, UT
• Providers in Bountiful, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.