Tracy Davies, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5518 Issued in WI

Practice address

2481 Executive Dr
East Troy, WI 53120

Phone

(262) 642-5695

NPI assigned

Mar 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Tracy Taylor Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Behrend Family Dentistry and Associates, S.C.

  • General Practice Dentistry
  • East Troy, WI
  • NPI 1346071859
  NPD (past)
• East Troy Family Dental Center SC

  • Dental Clinic/Center
  • East Troy, WI
  • NPI 1376607408
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386772986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 642",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "53120",
            "telephone_number": "262-642-5695",
            "fax_number": "262-642-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2481 EXECUTIVE DR",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "53120",
            "telephone_number": "262-642-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "TRACY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33781300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "391449280018",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "TAYLOR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Vanessa Cepeda, RN, IBCLC
• Cari A Chatham, BSN RN
• Compassionate Heart Counseling LLC
• Irene Corzo, LCPC
• Richard Datka, APRN
• Jody L Deboer, MSW, LCSW
• Vivian L Dehahn, APNP
• David F Devries, PA-C
• East Troy Area Emergency Services District
• East Troy Community School District

• Dentist in East Troy, WI
• Providers in East Troy, WI by specialty
• Dentist in Wisconsin

• 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.