Active NPI
Michael Asay Davis, D.D.S.
- Periodontics
- Casper, WY
National Provider Identifier
1568682011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 1274
- Practice address
- 5850 E 2ND St
Ste 100
Casper, WY 82609-4342 - Phone
- (307) 472-0207
- Fax
- (307) 472-0259
- NPI assigned
- Apr 26, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 1274 | WY | Primary |
Addresses
Primary practice location
5850 E 2ND St
Ste 100
Casper, WY 82609-4342
Mailing address
5850 E 2ND St
Ste 100
Casper, WY 82609-4342
Phone (307) 472-0207
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 |
|---|---|---|---|
| 1274 | WY | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310601600000",
"number": "1568682011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5850 E 2ND ST",
"address_2": "STE 100",
"city": "CASPER",
"state": "WY",
"postal_code": "826094342",
"telephone_number": "307-472-0207",
"fax_number": "307-472-0259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5850 E 2ND ST",
"address_2": "STE 100",
"city": "CASPER",
"state": "WY",
"postal_code": "826094342",
"telephone_number": "307-472-0207",
"fax_number": "307-472-0259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MICHAEL",
"middle_name": "ASAY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-26",
"last_updated": "2011-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "WY",
"license": "1274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Casper, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.