Susan E Davis, DDS – General Practice Dentistry

Key facts

NPI: 1629639349
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: DEN.00204062 (CO)
Practice address: 36 Oak St.
Buena Vista, CO 81211
Phone: (719) 966-5088
NPI assigned: Jun 24, 2019
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Ark Valley Dental, PLLC General Practice Dentistry · Buena Vista, CO · NPI 1972336261

NPD Authorized official GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
DEN.00204062	CO	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Ark Valley Dental, PLLC	General Practice	Current since Aug 25, 2024	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	DEN.00204062	CO	Yes

Addresses

Primary practice location

36 Oak St.
Buena Vista, CO 81211

Mailing address

PO Box 284
Buena Vista, CO 81211-0284
Phone (719) 966-5088

Other providers in Buena Vista, CO

All providers in Buena Vista, CO · General Practice Dentistry in Colorado

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.