Active NPI
Ted Arthur Davis, DDS MA
- Dentist
- Ontario, CA
National Provider Identifier
1619099314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 37811
- Practice address
- 1009 N Begonia Ave
Ontario, CA 91762 - Phone
- (909) 984-8015
- NPI assigned
- Apr 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 37811 | CA | Primary |
| Dentist | 122300000X | 6044 | IA |
Addresses
Primary practice location
1009 N Begonia Ave
Ontario, CA 91762
Mailing address
1009 N Begonia Ave
Ontario, CA 91762
Phone (909) 984-8015
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6044 | IA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619099314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 N BEGONIA AVE",
"city": "ONTARIO",
"state": "CA",
"postal_code": "91762",
"telephone_number": "909-984-8015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1009 N BEGONIA AVE",
"city": "ONTARIO",
"state": "CA",
"postal_code": "91762",
"telephone_number": "909-984-8015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "TED",
"middle_name": "ARTHUR",
"name_prefix": "Dr.",
"credential": "DDS MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "37811",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "6044",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.