Active NPI
Dale Carroll Davis, DDS
- Dentist
- Phoenix, AZ
National Provider Identifier
1659763597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2069
- Practice address
- 3132 N. 7TH St
Phoenix, AZ 85014 - Phone
- (602) 248-8176
- Fax
- (602) 230-0656
- NPI assigned
- Mar 2, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2069 | AZ | Primary |
Addresses
Primary practice location
3132 N. 7TH St
Phoenix, AZ 85014
Mailing address
3132 N. 7TH St
Phoenix, AZ 85014
Phone (602) 248-8176
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 084533 | Other | AZ | AHCCCS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 17, 2015 through Nov 17, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2069 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dale C Davis DDS PC | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Phoenix, AZ
- NPI 1093846586
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425254400000",
"number": "1659763597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3132 N. 7TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85014",
"telephone_number": "602-248-8176",
"fax_number": "602-230-0656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3132 N. 7TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85014",
"telephone_number": "602-248-8176",
"fax_number": "602-230-0656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DALE",
"middle_name": "CARROLL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-02",
"last_updated": "2015-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "2069",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS",
"identifier": "084533",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.