Faline Phucas Davenport

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401410720 Issued in VA

Practice address

7521 Virginia Oaks Dr Ste 230
Gainesville, VA 20155-3831

Phone

(703) 754-7151

Fax

(703) 754-1784

NPI assigned

Aug 5, 2006

Sex

Female

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

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272931200000",
    "number": "1497764096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13940 SHELTER MANOR DRIVE",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201696226",
            "telephone_number": "703-753-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7521 VIRGINIA OAKS DR STE 230",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553831",
            "telephone_number": "703-754-7151",
            "fax_number": "703-754-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUCAS DAVENPORT",
        "first_name": "FALINE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2010-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• VI Phan
• Pharmasutra PLLC
• David Randell Phelps, APRN
• Phoenix Counselinggroup and Play Therapycenter, PLLC
• Phoenix Family Counseling & Play Therapy Center, PLLC
• Michael R Pichardo, DDS
• Piedmont Professional Counseling
• Cecille M Pineda, PHARMD
• Jean Marie Pitt, CNA
• Mariano Andres Polack, DDS, MS

• General Practice Dentistry in Gainesville, VA
• Providers in Gainesville, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.