Active NPI
Anthony Lamar Davis, DDS
- General Practice Dentistry
- Jacksonville, FL
National Provider Identifier
1184766545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN19529
- Practice address
- NBHC Mayport
2104 Massey Avenue, Dental Dept
Jacksonville, FL 32228 - Phone
- (904) 270-4460
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401412732 | VA | |
| General Practice Dentistry | 1223G0001X | DN19529 | FL | Primary |
Addresses
Primary practice location
NBHC Mayport
2104 Massey Avenue, Dental Dept
Jacksonville, FL 32228
Mailing address
NBHC Mayport
2104 Massey Avenue, Dental Dept
Jacksonville, FL 32228
Phone (904) 270-4460
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 |
|---|---|---|---|
| DN19529 | FL | MD | General Practice Dentistry |
| 0401412732 | VA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691539200000",
"number": "1184766545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NBHC MAYPORT",
"address_2": "2104 MASSEY AVENUE, DENTAL DEPT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32228",
"telephone_number": "904-270-4460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NBHC MAYPORT",
"address_2": "2104 MASSEY AVENUE, DENTAL DEPT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32228",
"telephone_number": "904-270-4460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ANTHONY",
"middle_name": "LAMAR",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2023-08-09",
"certification_date": "2023-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401412732",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN19529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.