NPIMap

Organization Active NPI

Dr. Monica a. Davenport, DDS Apc

  • General Practice Dentistry
  • Shreveport, LA
National Provider Identifier
1720447147
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5001 Issued in LA
Legal business name
DR. MONICA A. DAVENPORT, DDS APC
Doing business as
Davenport Family Dental
Practice address
1850 Martin Luther King Dr.
Shreveport, LA 71107-5020
Phone
(318) 226-0244
Fax
(318) 226-0282
NPI assigned
Feb 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Authorized official

Name
Dr. Monica Annette Davenport, DDSNPI 1740224435
Title
Owner/Dentist
Phone
(318) 226-0244

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5001 LA Primary

Addresses

Primary practice location

1850 Martin Luther King Dr.
Shreveport, LA 71107-5020

Mailing address

1850 Martin Luther King Dr.
Shreveport, LA 71107-5020
Phone (318) 226-0244

Other identifiers 1

IdentifierTypeStateIssuer
1850012MedicaidLA

Other names 1

  • Davenport Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1850 Dr Martin Luther King Dr
Shreveport, LA 71107
Phone (318) 226-0244

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1720447147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 MARTIN LUTHER KING DR.",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711075020",
            "telephone_number": "318-226-0244",
            "fax_number": "318-226-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 MARTIN LUTHER KING DR.",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711075020",
            "telephone_number": "318-226-0244",
            "fax_number": "318-226-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MONICA A. DAVENPORT, DDS APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "ANNETTE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "318-226-0244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1850012",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davenport Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; 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.