Active NPI
Alphonzo Lowell Davidson Jr., D.D.S.
- General Practice Dentistry
- Washington, DC
National Provider Identifier
1265574685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11379
- Practice address
- 2811 Pennsylvania Ave SE
Washington, DC 20020-3865 - Phone
- (202) 584-0710
- Fax
- (202) 575-3627
- NPI assigned
- Feb 13, 2007
- Last updated
- Dec 22, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5474 | DC | |
| General Practice Dentistry | 1223G0001X | 11379 | MD | Primary |
Addresses
Primary practice location
2811 Pennsylvania Ave SE
Washington, DC 20020-3865
Mailing address
3308 Shortridge LN
Bowie, MD 20721-2576
Phone (202) 528-0440
Other practice location 1
9470 Annapolis Rd Ste 304
Lanham, MD 20706-3022
Phone (301) 731-4522
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 |
|---|---|---|---|
| 5474 | DC | MD | General Practice Dentistry |
| 11379 | MD | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hillgate LLC | Past | Accepting new patients |
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, 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": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703203200000",
"number": "1265574685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3308 SHORTRIDGE LN",
"city": "BOWIE",
"state": "MD",
"postal_code": "207212576",
"telephone_number": "202-528-0440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2811 PENNSYLVANIA AVE SE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200203865",
"telephone_number": "202-584-0710",
"fax_number": "202-575-3627"
}
],
"practiceLocations": [
{
"address_1": "9470 Annapolis Rd Ste 304",
"address_purpose": "LOCATION",
"city": "Lanham",
"state": "MD",
"postal_code": "207063022",
"country_code": "US",
"telephone_number": "301-731-4522",
"fax_number": "202-575-3627",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIDSON",
"first_name": "ALPHONZO",
"middle_name": "LOWELL",
"name_suffix": "Jr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2023-12-22",
"certification_date": "2023-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "DC",
"license": "5474",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "11379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.