Matthew Miller Davis, D.D.S

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12011656A Issued in IN

Practice address

8445 S Emerson Ave
Suite 100
Indianapolis, IN 46237-9596

Phone

(317) 882-1284

Fax

(317) 887-0844

NPI assigned

Jun 16, 2009

Sex

Male

Sole proprietor

No

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 IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial Surgery

Education

Indiana University School of Dentistry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Indiana Oral and Maxillofacial Surgery Associates PCGroup PAC ID 9335157254, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdavis152363@direct.franciscanalliance.org

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.

• Indiana Oral & Maxillofacial Surgery Associates PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Fishers, IN
  • NPI 1407809585

  IN, Oral and Maxillofacial Surgery

  Medicare reassignment Care Compare group NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1740417898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10972 ALLISONVILLE RD",
            "address_2": "SUITE 110",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382638",
            "telephone_number": "317-913-2363",
            "fax_number": "317-913-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8445 S EMERSON AVE",
            "address_2": "SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462379596",
            "telephone_number": "317-882-1284",
            "fax_number": "317-887-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MATTHEW",
        "middle_name": "MILLER",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12011656A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201097720",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marilyn Davis
• Martha M Davis, PSY.D.
• Mary Davis, CCC-SLP
• Mary Margaret Davis, M.D., M.S.
• Matthew James Davis
• Matthew Tsubasa Davis
• McKenzie Davis
• Melissa H Davis
• Michael Antonia Davis, D.D.S.
• Michelle Davis

• All providers in Indianapolis, IN
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.