Elbert R Davis, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN16694 Issued in FL

Practice address

201 Eglin Pkwy SE
Fort Walton Beach, FL 32548-5810

Phone

(850) 863-9050

Fax

(850) 863-5077

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sonny Davis Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1487746673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 EGLIN PKWY SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485810",
            "telephone_number": "850-863-9050",
            "fax_number": "850-863-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 EGLIN PKWY SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485810",
            "telephone_number": "850-863-9050",
            "fax_number": "850-863-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ELBERT",
        "middle_name": "R",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONNY",
            "last_name": "DAVIS",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Dana J. Wallace, LCSW, LLC
• Daniel Bader M.D., PA
• Hien Dao, MD
• Erica Darby
• Andrea Davis-Aguirre
• Ivey Danielle Davis, APRN
• Jessica Nicole Davis, OTR/L
• Joanna R. Davis, LMHC
• Max Reid Dawkins, PA-C
• Jeanie Sadler Dawson, LPN

• All providers in Fort Walton Beach, FL
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; 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.