Active NPI
Ryan Matthew Davis, D.D.S
- General Practice Dentistry
- Camp Lejeune, NC
National Provider Identifier
1710120621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 30-022957
- Practice address
- 2D Denbn/NDC 2DMLG
PCS Box 20130
Camp Lejeune, NC 28542-0130 - Phone
- (910) 451-2208
- Fax
- (910) 451-8036
- NPI assigned
- Apr 8, 2009
- 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 | 30-022957 | OH | Primary |
Addresses
Primary practice location
2D Denbn/NDC 2DMLG
PCS Box 20130
Camp Lejeune, NC 28542-0130
Mailing address
PCS Box 20130
2D Denbn/NDC 2DMLG
Camp Lejeune, NC 28542-0130
Phone (910) 451-2208
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 |
|---|---|---|---|
| 30-022957 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239148800000",
"number": "1710120621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PCS BOX 20130",
"address_2": "2D DENBN/NDC 2DMLG",
"city": "CAMP LEJEUNE",
"state": "NC",
"postal_code": "285420130",
"telephone_number": "910-451-2208",
"fax_number": "910-451-8036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2D DENBN/NDC 2DMLG",
"address_2": "PCS BOX 20130",
"city": "CAMP LEJEUNE",
"state": "NC",
"postal_code": "285420130",
"telephone_number": "910-451-2208",
"fax_number": "910-451-8036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "RYAN",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-08",
"last_updated": "2009-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30-022957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camp Lejeune, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.