Active NPI
Regina Davis, DDS
- Dentist
- Farmington Hills, MI
National Provider Identifier
1508935156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901017453
- Practice address
- 25882 Orchard Lake Rd Ste 105
Farmington Hills, MI 48336-1294 - Phone
- (248) 442-6600
- Fax
- (248) 564-0946
- NPI assigned
- Nov 7, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901017453 | MI | Primary |
Addresses
Primary practice location
25882 Orchard Lake Rd Ste 105
Farmington Hills, MI 48336-1294
Mailing address
9339 Mapletree Dr
Plymouth, MI 48170-3413
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4794086 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160318001286 | MI | Order and Referring Only - Oral Surgery | 1052618006 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508935156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9339 MAPLETREE DR",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481703413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25882 ORCHARD LAKE RD STE 105",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483361294",
"telephone_number": "248-442-6600",
"fax_number": "248-564-0946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "REGINA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901017453",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4794086",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.