Active NPI
Clifton Davison, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Fort Collins, CO
National Provider Identifier
1164514725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 3441
- Practice address
- 1513 Riverside Ave
Fort Collins, CO 80524-4348 - Phone
- (970) 484-4200
- Fax
- (970) 490-1490
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 3441 | CO | Primary |
Addresses
Primary practice location
1513 Riverside Ave
Fort Collins, CO 80524-4348
Mailing address
1513 Riverside Ave
Fort Collins, CO 80524-4348
Phone (970) 484-4200
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3441 | CO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164514725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1513 RIVERSIDE AVE",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805244348",
"telephone_number": "970-484-4200",
"fax_number": "970-490-1490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1513 RIVERSIDE AVE",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805244348",
"telephone_number": "970-484-4200",
"fax_number": "970-490-1490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVISON",
"first_name": "CLIFTON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CO",
"license": "3441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.