Bo M Davidson, D.D.S., M.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE60112868 Issued in WA

Practice address

8685 Martin Way E Ste 101
Lacey, WA 98516

Phone

(360) 489-1406

Fax

(360) 491-1270

NPI assigned

Apr 11, 2008

Last updated

Jul 3, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bdavidson319203@wm.providencedirect.org

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.

• Ehrmantrout & Davidson, PLLC

  dba Hawks Prairie Pediatric Dentistry/ West Olympia Kids Dentistry

  • Pediatric Dentistry
  • Lacey, WA
  • NPI 1134564032
  NPD (past)
• Zachary P Ehrmantrout DDS PS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Olympia, WA
  • NPI 1194681874
  NPD (past)

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1487827275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8685 MARTIN WAY SE STE 101",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "98516",
            "telephone_number": "360-489-1406",
            "fax_number": "360-491-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8685 MARTIN WAY E STE 101",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "98516",
            "telephone_number": "360-489-1406",
            "fax_number": "360-491-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "BO",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-11",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE60112868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adelina Georgieva Dana, M.A.
• Dandelion Nutrition LLC (Dandelion Nutrition)
• Michael John Dascenzo, L.M.P.
• David M. Warwick DC PLLC
• Claudia David
• Catherine Elizabeth Davis, LMP
• Christi Jean Davis
• Emma Davis
• Jenny Davis, LMT
• Julia Davis, PT

• Pediatric Dentistry in Lacey, WA
• Providers in Lacey, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.