Paul Davis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

WV3448 Issued in WV

Practice address

Audrey Egle Drive
Shepherdstown, WV 25443

Phone

(304) 876-3791

Fax

(304) 876-9229

NPI assigned

Nov 24, 2006

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

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356416259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1568",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "254431568",
            "telephone_number": "304-876-3791",
            "fax_number": "304-876-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AUDREY EGLE DRIVE",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "25443",
            "telephone_number": "304-876-3791",
            "fax_number": "304-876-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "WV3448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin C Cooper, LMT
• Yazmeen Cosley
• Ann Craig
• Amber Annette Cummins, LMT
• Jordan Lee Davis, PHARMD
• Michelle M Destefano, L.AC.
• Sue Ann Devall, LCSW
• David Didden, M.D.
• Kalilou Djobo
• Paula Black Donohue

• General Practice Dentistry in Shepherdstown, WV
• Providers in Shepherdstown, WV by specialty
• General Practice Dentistry in West Virginia

• 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.