Davidson Dental Interests LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DAVIDSON DENTAL INTERESTS LLC

Practice address

716 S Oakwood Ave
Brandon, FL 33511-6124

Phone

(813) 494-0091

NPI assigned

Sep 4, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Susan Agnes Davidson, DDSNPI 1104544782

Title

Dentist

Phone

(813) 494-0091

Specialties & licenses 1

Addresses

Other names 1

• Welly Dental Studio Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Agnes Davidson, DDS

  • Dentist
  • Brandon, FL
  • NPI 1104544782
  NPD Authorized official

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1689554164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11239 FISH EAGLE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335695742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 S OAKWOOD AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116124",
            "telephone_number": "813-494-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIDSON DENTAL INTERESTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "AGNES",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "813-494-0091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Welly Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michele Daubney
• Conner Daugherty, DO
• Javacia Kentori Davenport, APRN, PMHNP-BC
• Misti Marie Davenport, CFNP
• David J Busciglio DMD PA
• Susan Agnes Davidson, DDS
• Kayla Sarai Davila, BA, SLPA
• Amy Michelle Davis
• Brittney Davis
• Carolina Maria Davis, PHARMD, RPH

• Dental Clinic/Center in Brandon, FL
• Providers in Brandon, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.