Individual provider Active NPI

Vida Davis, D.D.S.

  • General Practice Dentistry
  • Abingdon, MD
National Provider Identifier
1477615094
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08631 Issued in MD
Practice address
2921 Emmorton Rd
Abingdon, MD 21009-1631
Phone
(410) 515-7525
NPI assigned
Dec 14, 2006
Last updated
Sep 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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 08631 MD Primary

Addresses

Primary practice location

2921 Emmorton Rd
Abingdon, MD 21009-1631

Mailing address

PO Box 439
Abingdon, MD 21009-0439
Phone (410) 515-7525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20160520001075 MD Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8224327887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08631MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr.V.Davis,PA General Practice Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1477615094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 439",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210090439",
            "telephone_number": "410-515-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 EMMORTON RD",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210091631",
            "telephone_number": "410-515-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "VIDA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "08631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, MD

Sources for this page

Verify at the official NPI Registry.