Organization Active NPI

Thomas E. Davey, D.M.D., P.C.

  • General Practice Dentistry
  • Decatur, IL
National Provider Identifier
1619050093
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
THOMAS E. DAVEY, D.M.D., P.C.
Practice address
1353 E Mound Rd Ste 201
Decatur, IL 62526-3678
Phone
(217) 877-2172
NPI assigned
Oct 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas E. Davey, D.M.D.
Title
President
Phone
(217) 877-2172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X IL Primary

Addresses

Primary practice location

1353 E Mound Rd Ste 201
Decatur, IL 62526-3678

Mailing address

1353 E Mound Rd Ste 201
Decatur, IL 62526-3678
Phone (217) 877-2172

National Provider Directory

National Provider Directory

Locations

1353 E Mound Rd
Ste 201
Decatur, IL 62526
Phone (217) 877-2172

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619050093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 E MOUND RD STE 201",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263678",
            "telephone_number": "217-877-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 E MOUND RD STE 201",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263678",
            "telephone_number": "217-877-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS E. DAVEY, D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-877-2172",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.