Luis John Davila, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3597429922 Issued in UT

Practice address

2507 Madison Ave
Ogden, UT 84401-2500

Phone

(801) 394-9428

Fax

(801) 394-9420

NPI assigned

Apr 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Vero Investments LLC

  • General Practice Dentistry
  • Ogden, UT
  • NPI 1871327940
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740406842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 W 4600 S",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840673320",
            "telephone_number": "801-732-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 MADISON AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844012500",
            "telephone_number": "801-394-9428",
            "fax_number": "801-394-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "LUIS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "3597429922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INSURANC",
            "identifier": "985377",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spencer Lance Davenport, PA-C
• David H Geddes DDS PC
• Jeffery Alan David, D.O; PHARM.D.
• Cami Davidson
• Richard S Davidson, MD
• Anthony Davis
• Camille Davis
• Jan Wayment Davis, APRN
• Jennifer Marie Davis, CSW
• Marianne Davis, MSW

• General Practice Dentistry in Ogden, UT
• Providers in Ogden, UT by specialty
• General Practice Dentistry in Utah

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.