Active NPI
Jamie Davenport, DMD
- General Practice Dentistry
- Fort Myers, FL
National Provider Identifier
1679658934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 16634
- Practice address
- 6150 Diamond Centre CT # 300-2
Fort Myers, FL 33912-4365 - Phone
- (239) 433-4746
- Fax
- (239) 433-5557
- NPI assigned
- Oct 26, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 16634 | FL | Primary |
Addresses
Primary practice location
6150 Diamond Centre CT # 300-2
Fort Myers, FL 33912-4365
Mailing address
7049 Mill Run Cir
Naples, FL 34109-7214
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16634 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679658934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7049 MILL RUN CIR",
"city": "NAPLES",
"state": "FL",
"postal_code": "341097214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6150 DIAMOND CENTRE CT # 300-2",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339124365",
"telephone_number": "239-433-4746",
"fax_number": "239-433-5557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVENPORT",
"first_name": "JAMIE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "16634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
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.