Individual provider Active NPI

Gerald Davis Jr., DDS

  • Dentist
  • Waukesha, WI
National Provider Identifier
1376335927
Registry record updated Jul 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6001876-15 Issued in WI
Practice address
N14W23833 Stone Ridge Dr Ste 100
Waukesha, WI 53188
Phone
(262) 542-8860
NPI assigned
May 20, 2025
Last updated
Jul 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6001876-15 WI Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

N14W23833 Stone Ridge Dr Ste 100
Waukesha, WI 53188

Mailing address

N14W23833 Stone Ridge Dr Ste 100
Waukesha, WI 53188-1189
Phone (262) 542-8860

Other practice location 1

1801 W Wisconsin Ave
Milwaukee, WI 53233-2186
Phone (414) 288-6790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6001876-15WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751587200000",
    "number": "1376335927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N14W23833 STONE RIDGE DR STE 100",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881189",
            "telephone_number": "262-542-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N14W23833 STONE RIDGE DR STE 100",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188",
            "telephone_number": "262-542-8860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532332186",
            "country_code": "US",
            "telephone_number": "414-288-6790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GERALD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-07-04",
        "certification_date": "2025-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001876-15",
            "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": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2025; 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.