Individual provider Active NPI

Thomas Naef Davenport, D.D.S.

  • Dentist
  • Kennewick, WA
National Provider Identifier
1558683052
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60862695 Issued in WA
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, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
100133CAMDDentist

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.