Individual provider Active NPI

John Patrick Davis, DDS

  • Pediatric Dentistry
  • Encinitas, CA
National Provider Identifier
1215181045
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
26834 Issued in CA
Practice address
477 N El Camino Real Ste B203
Encinitas, CA 92024-1353
Phone
(760) 942-1131
Fax
(760) 942-1708
NPI assigned
Nov 6, 2008
Last updated
Nov 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 26834 CA Primary

Addresses

Primary practice location

477 N El Camino Real Ste B203
Encinitas, CA 92024-1353

Mailing address

477 N El Camino Real Ste B203
Encinitas, CA 92024-1353
Phone (760) 942-1131

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

LicenseStateTypeSpecialty
26834CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
J. Patrick Davis & Matthew Davis Past Accepting new patients
Dental Specialty Associates Pediatric Dentistry Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225929600000",
    "number": "1215181045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL STE B203",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241353",
            "telephone_number": "760-942-1131",
            "fax_number": "760-942-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL STE B203",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241353",
            "telephone_number": "760-942-1131",
            "fax_number": "760-942-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-06",
        "last_updated": "2008-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "26834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.