Justin M Davenport, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60233 Issued in KS

Practice address

11225 Nall Ave
Suite 120
Leawood, KS 66211

Phone

(913) 345-1962

Fax

(913) 345-0365

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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

Medicare enrollment (NPD)

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.

• Leawood Family Dental LLC

  • General Practice Dentistry
  • Leawood, KS
  • NPI 1932273364
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295844108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11225 NALL AVE",
            "address_2": "SUITE 120",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "66211",
            "telephone_number": "913-345-1962",
            "fax_number": "913-345-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11225 NALL AVE",
            "address_2": "SUITE 120",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "66211",
            "telephone_number": "913-345-1962",
            "fax_number": "913-345-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "60233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francis Edward Dailey, M.D.
• Katherine Dalbey, LCSW, LSCSW
• Victoria Dalton, MS
• Kelci Dampf, OTR
• Daniel J Geha Mdpa
• David Varlotta LLC
• David W Peters MD PA
• Molly Moore McGraw Davidson
• Terrion Davidson, RBT
• Crystal Renee Davis, PA-C

• General Practice Dentistry in Leawood, KS
• Providers in Leawood, KS by specialty
• General Practice Dentistry in Kansas

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.