Individual provider Active NPI

Brian G Davis

  • Dentist
  • Kansas City, MO
National Provider Identifier
1669528998
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2004033307 Issued in MO
Practice address
9918 Holmes Rd Ste B
Kansas City, MO 64131-4306
Phone
(816) 943-0003
Fax
(816) 943-0034
NPI assigned
Jan 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2004033307 MO Primary

Addresses

Primary practice location

9918 Holmes Rd Ste B
Kansas City, MO 64131-4306

Mailing address

9918 Holmes Rd Ste B
Kansas City, MO 64131-4306
Phone (816) 943-0003

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2004033307MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Davis Family Dental, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669528998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9918 HOLMES RD STE B",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314306",
            "telephone_number": "816-943-0003",
            "fax_number": "816-943-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9918 HOLMES RD STE B",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314306",
            "telephone_number": "816-943-0003",
            "fax_number": "816-943-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRIAN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2004033307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

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.

Verify at the official NPI Registry.