Individual provider Active NPI

Pamela Beck Davis, D.D.S.

  • Dentist
  • Wheat Ridge, CO
National Provider Identifier
1669609251
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9937 Issued in CO
Practice address
10135 W 38TH Ave
Wheat Ridge, CO 80033-4003
Phone
(303) 431-5830
Fax
(303) 431-1324
NPI assigned
Jun 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9937 CO Primary

Addresses

Primary practice location

10135 W 38TH Ave
Wheat Ridge, CO 80033-4003

Mailing address

2903 Aspen Drive
Unit #G
Loveland, CO 80538
Phone (970) 667-6040

Other identifiers 1

IdentifierTypeStateIssuer
1669609251MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20220627002311 CO Order and Referring Only - DentistPractitioner - Dentist 0941689624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9937COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Dental Affiliates, PLLC PastSince Mar 12, 2023 Accepting new patients
Wheat Ridge Dental Group PLLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497484800000",
    "number": "1669609251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 ASPEN DRIVE",
            "address_2": "UNIT #G",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "80538",
            "telephone_number": "970-667-6040",
            "fax_number": "970-667-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10135 W 38TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334003",
            "telephone_number": "303-431-5830",
            "fax_number": "303-431-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "PAMELA",
        "middle_name": "BECK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2017-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "9937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669609251",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.