Individual provider Active NPI

Sharad C Davis, D.D.S.

  • Dentist
  • Midland, TX
National Provider Identifier
1710119219
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
24845 Issued in TX
Practice address
3200 Andrews Hwy
Ste400
Midland, TX 79701-3896
Phone
(432) 218-7926
Fax
(432) 218-7928
NPI assigned
Aug 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 24845 TX Primary

Addresses

Primary practice location

3200 Andrews Hwy
Ste400
Midland, TX 79701-3896

Mailing address

3200 Andrews Hwy
Ste 400
Midland, TX 79701-3896
Phone (432) 218-7926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20170404000831 IN Order and Referring Only - DentistPractitioner - Dentist 5395021422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24845TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Familia Dental Midland PLLC PastSince Jun 27, 2021 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.

NPI Registry JSON

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1710119219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 ANDREWS HWY",
            "address_2": "STE 400",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797013896",
            "telephone_number": "432-218-7926",
            "fax_number": "432-218-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 ANDREWS HWY",
            "address_2": "STE400",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797013896",
            "telephone_number": "432-218-7926",
            "fax_number": "432-218-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHARAD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-17",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "24845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

Verify at the official NPI Registry.