Mark Vincent Davis, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4549 Issued in FL

Practice address

14010 Roosevelt Blvd
Suite 704
Clearwater, FL 33762-3862

Phone

(727) 531-9363

Fax

(727) 535-3720

NPI assigned

Jul 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Mark V Davis DMD PLLC

  • General Practice Dentistry
  • Clearwater, FL
  • NPI 1962751370
  NPD (past) Authorized official
• General and Implant Dentistry of Tampa Bay, LLC

  • Dentist
  • Clearwater, FL
  • NPI 1821492703
  NPD (past)

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235337080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14010 ROOSEVELT BLVD",
            "address_2": "SUITE 704",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337623862",
            "telephone_number": "727-531-9363",
            "fax_number": "727-535-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14010 ROOSEVELT BLVD",
            "address_2": "SUITE 704",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337623862",
            "telephone_number": "727-531-9363",
            "fax_number": "727-535-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MARK",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "4549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "4549",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary S Davis, PT
• Jason Phillip Davis, PA-C
• Kathleen Kay Davis, APRN
• Lisa Davis, PA
• Mariah Davis
• Renee L Davis
• Teresa Davis, HS
• Dawn Potter, LLC
• Brian Dawson, D.C.
• Heather Dawson, ARNP-C

• General Practice Dentistry in Clearwater, FL
• Providers in Clearwater, FL by specialty
• General Practice Dentistry in Florida

• 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.

Verify at the official NPI Registry.