Bradlee Davis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6714 Issued in NV

Practice address

9680 S McCarran Blvd
Reno, NV 89523-9205

Phone

(775) 323-4054

Fax

(775) 323-4167

NPI assigned

Sep 30, 2015

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 NV

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

State licenses

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1437529641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9680 S MCCARRAN BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895239205",
            "telephone_number": "775-323-4054",
            "fax_number": "775-323-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9680 S MCCARRAN BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895239205",
            "telephone_number": "775-323-4054",
            "fax_number": "775-323-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRADLEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-30",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "6714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Davis-Coelho, PSY
• Noelle Marie Davis-Marinaccio, APRN, FNP-BC
• Aaron Davis
• Aliza Elizabeth Davis
• April Marie Davis
• Brian Neil Davis, M.D.
• Brittany Davis
• Bryana M Davis, PHARMD
• Charles S. Davis
• Christine Davis, LCSW

• General Practice Dentistry in Reno, NV
• Providers in Reno, NV by specialty
• General Practice Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.