Individual provider Active NPI

Daniel Davis Scott, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Evans, GA
National Provider Identifier
1508063181
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN013534 Issued in GA
Practice address
7011 Evans Town Center Blvd
Evans, GA 30809-4315
Phone
(706) 724-8735
Fax
(706) 722-7037
NPI assigned
Jun 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN013534 GA Primary

Addresses

Primary practice location

7011 Evans Town Center Blvd
Evans, GA 30809-4315

Mailing address

7011 Evans Town Center Blvd
Evans, GA 30809-4315
Phone (706) 724-8735

Other identifiers 3

IdentifierTypeStateIssuer
DN013534OtherGADENTIST
003110225GMedicaidGA
ZX7147MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130424000972 GA Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 5193961845 Reassigns benefits to 1 organization
I20170223002672 SC Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 5193961845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Medical College of Georgia School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Oral and Maxillofacial SurgeryGroup PAC ID 7618966573, 6 clinicians

Practice addresses (Care Compare)

101 Nut Grove Dr
North Augusta, SC 29841-2850
Phone (803) 278-2050

7011 Evans Town Ctr Blvd
Evans, GA 30809-4315
Phone (706) 724-8735

Hospital & facility affiliations

  • Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Oral & Maxillofacial Surgery Oral and Maxillofacial Surgery CurrentSince Mar 4, 2013 Accepting new patients

Locations

7011 Evans Town Center Blvd
Evans, GA 30809
Phone (706) 724-8735

1907 Pawnee St
Aiken, SC 29803
Phone (803) 649-3932

101 Nut Grove Dr
North Augusta, SC 29841
Phone (803) 278-2050

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486080000000",
    "number": "1508063181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7011 EVANS TOWN CENTER BLVD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094315",
            "telephone_number": "706-724-8735",
            "fax_number": "706-722-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 EVANS TOWN CENTER BLVD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094315",
            "telephone_number": "706-724-8735",
            "fax_number": "706-722-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "DANIEL",
        "middle_name": "DAVIS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2017-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN013534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "DN013534",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003110225G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX7147",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

Verify at the official NPI Registry.