Individual provider Active NPI

Sasha Davisson, DMD

  • General Practice Dentistry
  • West Chester, OH
National Provider Identifier
1730590944
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-024435 Issued in OH
Practice address
4845 Rialto Rd
Suite a
West Chester, OH 45069-2910
Phone
(513) 772-6500
Fax
(513) 772-2002
NPI assigned
May 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30-024435 OH Primary

Addresses

Primary practice location

4845 Rialto Rd
Suite a
West Chester, OH 45069-2910

Mailing address

4845 Rialto Rd
Suite a
West Chester, OH 45069-2910
Phone (513) 772-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150820009881 OH Order and Referring Only - DentistPractitioner - Dentist 4688989676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-024435OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1730590944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 RIALTO RD",
            "address_2": "SUITE A",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450692910",
            "telephone_number": "513-772-6500",
            "fax_number": "513-772-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 RIALTO RD",
            "address_2": "SUITE A",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450692910",
            "telephone_number": "513-772-6500",
            "fax_number": "513-772-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISSON",
        "first_name": "SASHA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-024435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

Verify at the official NPI Registry.