NPIMap

Organization Active NPI

Davenport Family Dentistry

  • General Practice Dentistry
  • Decatur, AL
National Provider Identifier
1306315890
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DAVENPORT FAMILY DENTISTRY
Doing business as
Davenport Family Dentistry
Practice address
2020 Stratford CT SE
Decatur, AL 35601-6553
Phone
(256) 355-0185
Fax
(256) 584-0100
NPI assigned
Nov 14, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Authorized official

Name
Dr. Justin M Bishop, DMDNPI 1437684107
Title
Owner/Dentist
Phone
(256) 355-0185

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2020 Stratford CT SE
Decatur, AL 35601-6553

Mailing address

2020 Stratford CT SE
Decatur, AL 35601-6553
Phone (256) 355-0185

Other identifiers 1

IdentifierTypeStateIssuer
1437684107OtherALNPI

Other names 1

  • Davenport Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

2020 Stratford Ct SE
Decatur, AL 35601
Phone (256) 355-0185

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542153600000",
    "number": "1306315890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 STRATFORD CT SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016553",
            "telephone_number": "256-355-0185",
            "fax_number": "256-584-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 STRATFORD CT SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016553",
            "telephone_number": "256-355-0185",
            "fax_number": "256-584-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVENPORT FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-14",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "256-355-0185",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437684107",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davenport Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.