Michael Larry Davidson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

06995 Issued in MD

Practice address

516 N Rolling Rd
Suite 207
Baltimore, MD 21228-4140

Phone

(410) 747-8029

Fax

(410) 747-5140

NPI assigned

Aug 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 17, 2017 through Jan 17, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538172903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 N ROLLING RD",
            "address_2": "SUITE 207",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212284140",
            "telephone_number": "410-747-8029",
            "fax_number": "410-747-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 N ROLLING RD",
            "address_2": "SUITE 207",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212284140",
            "telephone_number": "410-747-8029",
            "fax_number": "410-747-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "MICHAEL",
        "middle_name": "LARRY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "06995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Nicole Davidson
• Hannah Rochelle Davidson, CGC
• Jack Allen Davidson III, DDS
• Jeffrey Davidson, LCSW-C, LICSW
• Joseph Davidson, DDS
• Robert Gregory Davidson, M.D.
• Ryan Davidson, DPT, PT
• Ernest Davila, C.R.N.A.
• Esteban Davila
• Rose Marie Davila

• General Practice Dentistry in Baltimore, MD
• Providers in Baltimore, MD by specialty
• General Practice Dentistry in Maryland

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.