Individual provider Active NPI

David W Davidson, DDS

  • General Practice Dentistry
  • Urbandale, IA
National Provider Identifier
1447310149
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6557 Issued in IA
Practice address
8573 Urbandale Ave
Urbandale, IA 50322
Phone
(515) 279-3848
Fax
(515) 279-4479
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6557 IA Primary

Addresses

Primary practice location

8573 Urbandale Ave
Urbandale, IA 50322

Mailing address

8573 Urbandale Ave
Urbandale, IA 50322
Phone (515) 279-3848

Other identifiers 3

IdentifierTypeStateIssuer
4007496OtherIAWELLMARK BLUE DENTAL
0005207MedicaidIA
170589OtherIADELTA DENTAL OF IA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20170126000785 IA Order and Referring Only - DentistPractitioner - Dentist 9537470521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6557IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Davidson Family Dentistry, LLC Past Accepting new patients
Davidson Family Dentistry General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447310149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8573 URBANDALE AVE",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "50322",
            "telephone_number": "515-279-3848",
            "fax_number": "515-279-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8573 URBANDALE AVE",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "50322",
            "telephone_number": "515-279-3848",
            "fax_number": "515-279-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE DENTAL",
            "identifier": "4007496",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005207",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL OF IA",
            "identifier": "170589",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbandale, IA

Sources for this page

Verify at the official NPI Registry.