Active NPI
Mark Stephen Davis, DDS
- Dentist
- Scottsdale, AZ
National Provider Identifier
1609964436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D7222
- Practice address
- 34522 N Scottsdale Rd
Suite D5
Scottsdale, AZ 85266-1224 - Phone
- (480) 595-1300
- NPI assigned
- Oct 10, 2006
- 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 | D7222 | AZ | Primary |
Addresses
Primary practice location
34522 N Scottsdale Rd
Suite D5
Scottsdale, AZ 85266-1224
Mailing address
34522 N Scottsdale Rd
Suite D-5
Scottsdale, AZ 85266-1224
Phone (480) 595-1300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150605002153 | AZ | Order and Referring Only - Oral Surgery | 5395066062 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7222 | AZ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1609964436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34522 N SCOTTSDALE RD",
"address_2": "SUITE D-5",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852661224",
"telephone_number": "480-595-1300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34522 N SCOTTSDALE RD",
"address_2": "SUITE D5",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852661224",
"telephone_number": "480-595-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MARK",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D7222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.