Organization Active NPI

George a,. Davis, Jr., D.D.S., Professional Corporation

  • Dentist
  • Glendora, CA
National Provider Identifier
1295935328
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
295877 Issued in CA
Legal business name
GEORGE A,. DAVIS, JR., D.D.S., PROFESSIONAL CORPORATION
Practice address
906 S Grand Ave
Glendora, CA 91740-4808
Phone
(626) 852-9500
Fax
(702) 562-9610
NPI assigned
Jul 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. George Arnold Davis, D.D.S.
Title
Owner
Phone
(626) 852-9500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 295877 CA Primary

Addresses

Primary practice location

906 S Grand Ave
Glendora, CA 91740-4808

Mailing address

906 S Grand Ave
Glendora, CA 91740-4808
Phone (626) 852-9500

Other names 1

  • Glendora Dental Surgery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
George a Davis Jr DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295935328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404808",
            "telephone_number": "626-852-9500",
            "fax_number": "702-562-9610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404808",
            "telephone_number": "626-852-9500",
            "fax_number": "702-562-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE A,. DAVIS, JR., D.D.S., PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "ARNOLD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-852-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "295877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glendora Dental Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.