Individual provider Active NPI

Daniel K. Davidian, DDS

  • General Practice Dentistry
  • Raleigh, NC
National Provider Identifier
1306969506
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
200001357583 Issued in NC
Practice address
3917 Sunset Ridge Rd
Raleigh, NC 27607-6415
Phone
(919) 783-9686
Fax
(919) 783-0371
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 200001357583 NC Primary

Addresses

Primary practice location

3917 Sunset Ridge Rd
Raleigh, NC 27607-6415

Mailing address

3917 Sunset Ridge Rd
Raleigh, NC 27607-6415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20171205002797 NC Order and Referring Only - DentistPractitioner - Dentist 6608168414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7421NCMDProfessional Counselor
200001357583NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Davidian & Associates General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306969506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 SUNSET RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 SUNSET RIDGE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076415",
            "telephone_number": "919-783-9686",
            "fax_number": "919-783-0371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDIAN",
        "first_name": "DANIEL",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "200001357583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.