Active NPI
Thomas Naef Davenport, D.D.S.
- Dentist
- Kennewick, WA
National Provider Identifier
1558683052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60862695
- Practice address
- 7405 W Grandridge Blvd Ste B
Kennewick, WA 99336-6708 - Phone
- (509) 783-8161
- Fax
- (509) 783-0327
- NPI assigned
- Feb 24, 2010
- Last updated
- Sep 30, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 100133 | CA | |
| Dentist | 122300000X | DE60862695 | WA | Primary |
Addresses
Primary practice location
7405 W Grandridge Blvd Ste B
Kennewick, WA 99336-6708
Mailing address
4225 E McDowell Rd Apt 2103
Phoenix, AZ 85008-7473
Phone (410) 440-9703
Other practice location 1
4225 E McDowell Rd Apt 2103
Phoenix, AZ 85008-7473
Phone (410) 440-9703
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100133 | CA | MD | Dentist |
Interoperability endpoints
- thomas.davenport.1@21034.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790726400000",
"number": "1558683052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4225 E MCDOWELL RD APT 2103",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850087473",
"telephone_number": "410-440-9703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7405 W GRANDRIDGE BLVD STE B",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993366708",
"telephone_number": "509-783-8161",
"fax_number": "509-783-0327"
}
],
"practiceLocations": [
{
"address_1": "4225 E McDowell Rd Apt 2103",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850087473",
"country_code": "US",
"telephone_number": "410-440-9703",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVENPORT",
"first_name": "THOMAS",
"middle_name": "NAEF",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-24",
"last_updated": "2026-09-30",
"certification_date": "2026-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "100133",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60862695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.