Active NPI
Robert John Davidson, DDS
- Dentist
- Mount Vernon, OH
National Provider Identifier
1578520078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30018495
- Practice address
- 809 Coshocton Avenue
Suite E
Mt Vernon, OH 43050 - Phone
- (740) 392-6826
- NPI assigned
- Apr 27, 2006
- Last updated
- Feb 24, 2009
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 30018495 | OH | Primary |
Addresses
Primary practice location
809 Coshocton Avenue
Suite E
Mt Vernon, OH 43050
Mailing address
809 Coshocton Avenue
Suite E
Mt Vernon, OH 43050
Phone (740) 392-6826
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 |
|---|---|---|---|
| 30018495 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235433600000",
"number": "1578520078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 COSHOCTON AVENUE",
"address_2": "SUITE E",
"city": "MT VERNON",
"state": "OH",
"postal_code": "43050",
"telephone_number": "740-392-6826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 COSHOCTON AVENUE",
"address_2": "SUITE E",
"city": "MT VERNON",
"state": "OH",
"postal_code": "43050",
"telephone_number": "740-392-6826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "ROBERT",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-27",
"last_updated": "2009-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30018495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.