Individual provider Active NPI

Jennifer D Davis, DMD

  • General Practice Dentistry
  • Birmingham, AL
National Provider Identifier
1508955923
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4363 Issued in AL
Practice address
2828 Central Ave
Birmingham, AL 35209-2504
Phone
(205) 871-2592
Fax
(205) 871-2506
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4363 AL Primary

Addresses

Primary practice location

2828 Central Ave
Birmingham, AL 35209-2504

Mailing address

2828 Central Ave
Birmingham, AL 35209-2504
Phone (205) 871-2592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20150603001267 AL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3274854229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4363ALMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Melissa S Nix DMD LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1508955923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 CENTRAL AVE",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352092504",
            "telephone_number": "205-871-2592",
            "fax_number": "205-871-2506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 CENTRAL AVE",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352092504",
            "telephone_number": "205-871-2592",
            "fax_number": "205-871-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.