Individual provider Active NPI

Robert Michael Davis, D.M.D.

  • Dentist
  • Voorhees, NJ
National Provider Identifier
1457556060
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DIO18429 Issued in NJ
Practice address
2301 E Evesham Rd
Suite 506
Voorhees, NJ 08043-4501
Phone
(856) 772-0888
Fax
(856) 772-3668
NPI assigned
Jun 15, 2007
Sex
Male
Sole proprietor
Yes

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
Dentist 122300000X DIO18429 NJ Primary

Addresses

Primary practice location

2301 E Evesham Rd
Suite 506
Voorhees, NJ 08043-4501

Mailing address

2301 E Evesham Rd
Suite 506
Voorhees, NJ 08043-4501
Phone (856) 772-0888

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
DIO18429NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457556060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 E EVESHAM RD",
            "address_2": "SUITE 506",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434501",
            "telephone_number": "856-772-0888",
            "fax_number": "856-772-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E EVESHAM RD",
            "address_2": "SUITE 506",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434501",
            "telephone_number": "856-772-0888",
            "fax_number": "856-772-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DIO18429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • 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.