George Ryan Davis, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D10353 Issued in OR

Practice address

244 E Ellendale Ave Ste 4
Dallas, OR 97338-1523

Phone

(503) 400-6994

Fax

(503) 623-7598

NPI assigned

Mar 2, 2010

Last updated

Feb 27, 2023By 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

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

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.

• Brock J Nelson DMD LLC

  • Dental Clinic/Center
  • Salem, OR
  • NPI 1104782077
  NPD (past)
• Nelson and Willis LLC

  dba Willis Dental

  • General Practice Dentistry
  • Salem, OR
  • NPI 1225782261
  NPD (past)

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1366765687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 E ELLENDALE AVE STE 4",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381523",
            "telephone_number": "503-400-6994",
            "fax_number": "503-623-7598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 E ELLENDALE AVE STE 4",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381523",
            "telephone_number": "503-400-6994",
            "fax_number": "503-623-7598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "631 Jason St NE Ste 150",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973012318",
            "country_code": "US",
            "telephone_number": "503-364-3004",
            "fax_number": "503-364-1623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12750 SE Stark St Bldg E",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972331539",
            "country_code": "US",
            "telephone_number": "971-347-3009",
            "fax_number": "971-256-3277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GEORGE",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-02",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Roth Darling, MS
• Marlisha Darr, QMHP
• Darrington Physical Therapy LLC
• Amanda Rose David
• Jessica Lynn Davidson
• Karen Davis
• Mark Lynn Davis, CADC I
• Thomas L Davis Jr., D.M.D.
• Kristoffer De Leon
• Deborah R Saxby (Just Relax)

• General Practice Dentistry in Dallas, OR
• Providers in Dallas, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.