Individual provider Active NPI

Draak Karras Davis, D.M.D

  • Dentist
  • Rockwall, TX
National Provider Identifier
1578837837
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
32633 Issued in TX
Practice address
1039 E Interstate 30
Suite 107
Rockwall, TX 75087-4899
Phone
(707) 372-6928
NPI assigned
Mar 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 32633 TX Primary
Dentist 122300000X 60565 CA

Addresses

Primary practice location

1039 E Interstate 30
Suite 107
Rockwall, TX 75087-4899

Mailing address

1039 E Interstate 30
Suite 107
Rockwall, TX 75087-4899
Phone (707) 372-6928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170621001277 TX Order and Referring Only - DentistPractitioner - Dentist 7416225164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32633TXMDDentist
60565CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1578837837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 E INTERSTATE 30",
            "address_2": "SUITE 107",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874899",
            "telephone_number": "707-372-6928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 E INTERSTATE 30",
            "address_2": "SUITE 107",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874899",
            "telephone_number": "707-372-6928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DRAAK",
        "middle_name": "KARRAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-05",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "32633",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60565",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

Verify at the official NPI Registry.