Darrell W. Davis, DDS, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15136 Issued in MO

Practice address

17020 E US Highway 40
Suite #7
Independence, MO 64055-5361

Phone

(816) 350-7710

Fax

(816) 350-7711

NPI assigned

Jan 9, 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

Medicare fee-for-service enrollment

Enrolled in MO

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

Locations

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.

• Special Care Dental of Missouri LLC

  • Dentist
  • Leawood, KS
  • NPI 1790127512

  MO

  Medicare reassignment NPD
• Darrell W. Davis, D.D.S., P.C

  • Dentist
  • Independence, MO
  • NPI 1356547780
  NPD (past) Authorized official

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750430955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17020 E US HIGHWAY 40",
            "address_2": "SUITE #7",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555361",
            "telephone_number": "816-350-7710",
            "fax_number": "816-350-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17020 E US HIGHWAY 40",
            "address_2": "SUITE #7",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555361",
            "telephone_number": "816-350-7710",
            "fax_number": "816-350-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DARRELL",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "DDS, PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "15136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Daugherty
• Valentenia Daugherty, D.P.M.
• Lindsey Marie Daum
• Kim M Davies, M.D.
• Cuba S Davis, LPC
• Jessica Davis, M.A., CCC-SLP
• Kelly Davis, M.A., CCC-SLP
• Madison Davis
• Marquita Davis
• Nicholas Davis, DPT

• General Practice Dentistry in Independence, MO
• Providers in Independence, MO by specialty
• General Practice Dentistry in Missouri

• 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.