Active NPI
Lawrence Huebert Davis, DDS
- General Practice Dentistry
- Wichita, KS
National Provider Identifier
1730280280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5808
- Practice address
- 3001 E Central Ave
Wichita, KS 67214-4814 - Phone
- (316) 685-9791
- Fax
- (316) 685-6319
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5808 | KS | Primary |
| General Practice Dentistry | 1223G0001X | 014207 | MO |
Addresses
Primary practice location
3001 E Central Ave
Wichita, KS 67214-4814
Mailing address
3001 E Central Ave
Wichita, KS 67214-4814
Phone (316) 685-9791
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100222490B | Medicaid | KS | |
| 019212 | Other | KS | BLUE CROSS BLUE SHIELD |
Other names 1
- Dr. Larry Hueber Davis
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 |
|---|---|---|---|
| 5808 | KS | MD | General Practice Dentistry |
| 014207 | MO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Larry H Davis DDS PA | General Practice | Past | 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": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730280280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 E CENTRAL AVE",
"city": "WICHITA",
"state": "KS",
"postal_code": "672144814",
"telephone_number": "316-685-9791",
"fax_number": "316-685-6319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 E CENTRAL AVE",
"city": "WICHITA",
"state": "KS",
"postal_code": "672144814",
"telephone_number": "316-685-9791",
"fax_number": "316-685-6319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LAWRENCE",
"middle_name": "HUEBERT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KS",
"license": "5808",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "014207",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100222490B",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "019212",
"state": "KS"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LARRY",
"last_name": "DAVIS",
"middle_name": "HUEBER",
"prefix": "DR.",
"credential": "DDS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Wichita, KS
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.