Active NPI
Laura Beth Davis, DMD
- Dentist
- Mobile, AL
National Provider Identifier
1154434561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3665
- Practice address
- 1303 Dr Martin L King Jr Ave
Mobile, AL 36603-5341 - Phone
- (251) 432-4117
- Fax
- (251) 964-4012
- NPI assigned
- Aug 17, 2006
- Sex
- Female
- 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 | 3665 | AL | Primary |
Addresses
Primary practice location
1303 Dr Martin L King Jr Ave
Mobile, AL 36603-5341
Mailing address
PO Box 2048
Mobile, AL 36652-2048
Phone (251) 432-4117
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126402 | Medicaid | AL | |
| 511-3755 | Other | AL | BCBS |
| 1154434561 | Other | AL | NPI |
| 3665 | Other | AL | STATE LICENSE |
| 511-13757 | Other | AL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- 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 |
|---|---|---|---|---|
| I20160112003261 | AL | Order and Referring Only - Oral Surgery | 2062714751 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3665 | AL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323302400000",
"number": "1154434561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2048",
"city": "MOBILE",
"state": "AL",
"postal_code": "366522048",
"telephone_number": "251-432-4117",
"fax_number": "251-964-4012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1303 DR MARTIN L KING JR AVE",
"city": "MOBILE",
"state": "AL",
"postal_code": "366035341",
"telephone_number": "251-432-4117",
"fax_number": "251-964-4012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LAURA",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-17",
"last_updated": "2011-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AL",
"license": "3665",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "126402",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "511-3755",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1154434561",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "3665",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "511-13757",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.