Gerald Dewayne Davis, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

4461-83 Issued in OK

Practice address

1309 Jackie Rd
Duncan, OK 73533-1566

Phone

(580) 255-3570

Fax

(580) 255-5015

NPI assigned

Mar 13, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gerald Davis, DDS, Inc PC

  • Dentist
  • Duncan, OK
  • NPI 1104923465
  NPD (past) Authorized official
• Gerald D Davis DDS Inc PC

  • General Practice Dentistry
  • Duncan, OK
  • NPI 1164500328
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316070220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 JACKIE RD",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331566",
            "telephone_number": "580-255-3570",
            "fax_number": "580-255-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 JACKIE RD",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331566",
            "telephone_number": "580-255-3570",
            "fax_number": "580-255-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GERALD",
        "middle_name": "DEWAYNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "4461-83",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Doreen Marie Delong, APN
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• Dentist in Duncan, OK
• Providers in Duncan, OK by specialty
• Dentist in Oklahoma

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.