NPIMap

Organization Active NPI

Brian Davidson DDS PC

  • Dentist
  • Clarkston, MI
National Provider Identifier
1467600528
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901018686 Issued in MI
Legal business name
BRIAN DAVIDSON DDS PC
Practice address
5720 Clarkston Road
Clarkston, MI 48348
Phone
(248) 620-6200
Fax
(248) 620-6250
NPI assigned
Sep 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Authorized official

Name
Dr. Brian P. Davidson, DMDNPI 1548481849
Title
President / Dentist
Phone
(248) 620-6200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 2901018686 MI Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 2901019449 MI

Addresses

Primary practice location

5720 Clarkston Road
Clarkston, MI 48348

Mailing address

5720 Clarkston Road
Clarkston, MI 48348
Phone (248) 620-6200

Other names 1

  • Professional Dental of Clarkston Doing business as

National Provider Directory

National Provider Directory

Locations

5720 Clarkston Rd
Clarkston, MI 48348
Phone (248) 620-6200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1467600528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 CLARKSTON ROAD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48348",
            "telephone_number": "248-620-6200",
            "fax_number": "248-620-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 CLARKSTON ROAD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48348",
            "telephone_number": "248-620-6200",
            "fax_number": "248-620-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN DAVIDSON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT / DENTIST",
        "authorized_official_telephone_number": "248-620-6200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901018686",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019449",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Dental of Clarkston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.