Matthew Dale Davenport, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30131 Issued in TX

Practice address

3402 E del Mar Blvd Ste 260
Laredo, TX 78041-6599

Phone

(956) 324-5523

NPI assigned

Jun 19, 2014

Sex

Male

Sole proprietor

No

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 TX

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

Practice roles

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.

• Dick B. Davenport, D.D.S., P.C.

  dba Dick B. Davenport, D.D.S. and Associates

  • General Practice Dentistry
  • Laredo, TX
  • NPI 1497855761
  NPD (past)

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1154735942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 JUNCTION DR",
            "address_2": "SUITE D",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416511",
            "telephone_number": "956-726-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 E DEL MAR BLVD STE 260",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416599",
            "telephone_number": "956-324-5523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 Junction Dr",
            "address_2": "Suite D",
            "address_purpose": "LOCATION",
            "city": "Laredo",
            "state": "TX",
            "postal_code": "780416511",
            "country_code": "US",
            "telephone_number": "956-726-9980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "MATTHEW",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "30131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daily Health Services (Daily Adult Day Care)
• Daily Health Sevices, Inc. (Daily Primary Home Care)
• Timothy Dalley, OD
• Heramb Ankleshkumar Dave, MD
• Dick B Davenport, D.D.S.
• David E. Garza, D.O, P.a.
• David H Cruz MD PA
• David R. Benavides M.D., P.a.
• David Saul Mora O.D, PH.D , P.C.
• Elia Eliza Davila, LCSW

• General Practice Dentistry in Laredo, TX
• Providers in Laredo, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.