Active NPI
Brett Earl Davis, DMD
- Dentist
- St George, UT
National Provider Identifier
1295099216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 83228799921
- Practice address
- 2134 E Riverside Dr Ste B3
St George, UT 84790-2637 - Phone
- (435) 628-5505
- Fax
- (435) 628-5118
- NPI assigned
- Jun 25, 2012
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6296 | NV | |
| Dentist | 122300000X | 83228799921 | UT | Primary |
Addresses
Primary practice location
2134 E Riverside Dr Ste B3
St George, UT 84790-2637
Mailing address
2134 E Riverside Dr Ste B3
St George, UT 84790-2637
Phone (435) 628-5505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83228799921 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653350400000",
"number": "1295099216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2134 E RIVERSIDE DR STE B3",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847902637",
"telephone_number": "435-628-5505",
"fax_number": "435-628-5118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2134 E RIVERSIDE DR STE B3",
"city": "ST GEORGE",
"state": "UT",
"postal_code": "847902637",
"telephone_number": "435-628-5505",
"fax_number": "435-628-5118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "BRETT",
"middle_name": "EARL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-25",
"last_updated": "2022-05-24",
"certification_date": "2022-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "6296",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "83228799921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.