Ellwood Louis Davidson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE00008809 Issued in WA

Practice address

2124 4TH Ave
Seattle, WA 98121-2308

Phone

(206) 296-4755

Fax

(206) 296-0184

NPI assigned

Jun 21, 2008

Last updated

Jun 21, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: edavidson178936@direct.ochin.org

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

{
    "created_epoch": "1214006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214006400000",
    "number": "1558522623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 S LANE ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981443016",
            "telephone_number": "206-329-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 4TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212308",
            "telephone_number": "206-296-4755",
            "fax_number": "206-296-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "ELLWOOD",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-21",
        "last_updated": "2008-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00008809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy S David, PHD
• Ann Demaris Davids, M.S.W.
• Carol Davidson, CDP
• Christine A Davidson, RD
• Darin Justyn Davidson, MD
• Giana Hystad Davidson, MD
• Jay Davidson, MD
• Jennifer Elizabeth Davidson
• Julene Davidson, OTR/L
• Julie Jean Davidson, MC60560021

• Dentist in Seattle, WA
• Providers in Seattle, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2008; 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.

Verify at the official NPI Registry.