Richard Ryan Davis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D4373 Issued in ID

Practice address

9502 W Fairview Ave
Boise, ID 83704-8103

Phone

(208) 377-2223

NPI assigned

Jun 25, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1598076473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24239 EL PASO RD",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836075524",
            "telephone_number": "208-440-7384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9502 W FAIRVIEW AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048103",
            "telephone_number": "208-377-2223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24239 El Paso Rd",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "ID",
            "postal_code": "836075524",
            "country_code": "US",
            "telephone_number": "208-440-7384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RICHARD",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08711",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nickalus Shane Davis, PT
• Paige Davis
• Patricia Marie Davis, LCSW
• Rachel Lynne Davis, AGACNP-BC
• Rebecca Davis, LMSW
• Robert Davis
• Robert Davis
• Robert W Davis, MD
• Steven Davis, PA-C
• Taylor Anne Davis, PT

• All providers in Boise, ID
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.