John Andrew Davis, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12287 Issued in NC

Practice address

2090 Waterscape Way
New Bern, NC 28562

Phone

(252) 631-3260

NPI assigned

May 19, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Southern Oaks Dental

  • Dental Clinic/Center
  • New Bern, NC
  • NPI 1568302503
  NPD (past)

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1528632999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 OLD AIRPORT RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285628790",
            "telephone_number": "252-799-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 WATERSCAPE WAY",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "28562",
            "telephone_number": "252-631-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-19",
        "last_updated": "2024-07-05",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "12287",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David B. Baxter, OD, PA
• Andrew Davidson, M.D.
• Theresa Davidson
• Alexandria Davis
• Brooke S Davis, OTR/L
• Kaitlin Davis
• Michael Lee Davis, MD
• Simone Davis
• Wendy Peek Davis, FNP
• Delaney Dawson

• General Practice Dentistry in New Bern, NC
• Providers in New Bern, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.