Individual provider Active NPI

John Rance Davis, D.D.S.

  • Dentist
  • Rogers, AR
National Provider Identifier
1225057029
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4911 Issued in AR
Practice address
508 S 52ND St
Rogers, AR 72758-8600
Phone
(479) 845-1191
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4911 AR Primary
Public Health Dentistry 1223D0001X 2020022988 MO
General Practice Dentistry 1223G0001X 19572 TX

Addresses

Primary practice location

508 S 52ND St
Rogers, AR 72758-8600

Mailing address

508 S 52ND St
Rogers, AR 72758-8600
Phone (479) 845-1191

Other identifiers 4

IdentifierTypeStateIssuer
2020022988OtherMOSTATE LICENSE
752849726OtherTAX ID
4911OtherARDENTAL LICENSE
19572OtherTXSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20200820000111 MO Order and Referring Only - DentistPractitioner - Dentist 8325464621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4911ARMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Metropark Dental Arts General Practice Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rdavis720955@direct.ochin.org
  • Direct secure messaging: rance.davis.p1@direct.jordanvalley.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1225057029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 S 52ND ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588600",
            "telephone_number": "479-845-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S 52ND ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588600",
            "telephone_number": "479-845-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOHN",
        "middle_name": "RANCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "4911",
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MO",
            "license": "2020022988",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19572",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2020022988",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "752849726",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "4911",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "19572",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.