Zachery Tyler Davis

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DDS105061 Issued in CA

Practice address

7525 N Cedar Ave Ste 105
Fresno, CA 93720-2698

Phone

(559) 439-6600

NPI assigned

Mar 8, 2018

Last updated

Jul 31, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1336641000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 MINARETS LN",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116995",
            "telephone_number": "801-946-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 N CEDAR AVE STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202698",
            "telephone_number": "559-439-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8110 Birmingham Way Bldg 28",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921232758",
            "country_code": "US",
            "telephone_number": "619-205-1950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ZACHERY",
        "middle_name": "TYLER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-08",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "DDS105061",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonieka Davis
• Vanessa Davis, MS
• Veronica M Davis, LC, MA, CHLP
• Wendy Davis
• William Jerrod Davis
• Irma Louise Davison, FNP
• Steven Davison
• Sina Davoudi
• Milena Davoyan, APCC
• Shirlene Ann Daw, NP

• Pediatric Dentistry in Fresno, CA
• Providers in Fresno, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.