Individual provider Active NPI

Erica Davis, DMD

  • Dentist
  • Dorchester Center, MA
National Provider Identifier
1376996561
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1857713 Issued in MA
Practice address
637 Washington St
Dorchester Center, MA 02124-3510
Phone
(617) 825-9660
NPI assigned
Jul 22, 2016
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1857713 MA Primary

Addresses

Primary practice location

637 Washington St
Dorchester Center, MA 02124-3510

Mailing address

637 Washington St
Dorchester Center, MA 02124-3510
Phone (617) 825-9220

Other practice location 1

830 Chalkstone Ave
Providence, RI 02908-4734
Phone (401) 457-3018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20171127000955 MA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6901163120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1857713MAMDDentist

Interoperability endpoints

  • Direct secure messaging: edavis211898@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376996561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-825-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-825-9660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Chalkstone Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029084734",
            "country_code": "US",
            "telephone_number": "401-457-3018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ERICA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester Center, MA

Sources for this page

Verify at the official NPI Registry.