Matthew S Davidson, DMD

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

FD6830308 Issued in FL

Practice address

5611 Sheldon Rd
Tampa, FL 33615-3532

Phone

(813) 397-5320

NPI assigned

Jul 10, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499644800000",
    "number": "1629590880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5611 SHELDON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336153532",
            "telephone_number": "813-397-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5611 SHELDON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336153532",
            "telephone_number": "813-397-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "MATTHEW",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "FL",
            "license": "FD6830308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Hatcher Davidson, MA
• Alexander Reuben Davidson, LCSW
• Arlene A Davidson
• Brandy Letoy Davidson, LMFT
• Cheyanne Davidson
• Meredith Davidson, BCBA
• Michael Davidson, APRN-FNP-BC
• Patricia Ann Davidson, RN LMHC
• Rachel Davidson, PH.D.
• Wayne Edward Davidson, LMHC

• Public Health Dentistry in Tampa, FL
• Providers in Tampa, FL by specialty
• Public Health Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; 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.

Verify at the official NPI Registry.