Trevor M Davis, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DD4303 Issued in NM

Practice address

120 E Hwy 550
Bernalillo, NM 87004-5967

Phone

(505) 393-5555

NPI assigned

Jun 11, 2015

Last updated

Jan 4, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NM

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

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1750762076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E HWY 550",
            "city": "BERNALILLO",
            "state": "NM",
            "postal_code": "870045967",
            "telephone_number": "505-393-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E HWY 550",
            "city": "BERNALILLO",
            "state": "NM",
            "postal_code": "870045967",
            "telephone_number": "505-393-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TREVOR",
        "middle_name": "M",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Elizabeth Cornell, MA, LPCC
• Juanita Correa
• County of Sandoval
• Crestview Hospice LLC
• Lesley Davidson-Boyd, LMHC
• Teresita Amanda De la Torre, M.A., SLP
• Alexandra De Vere, LMHC
• Tanya C Deets
• Gabriel Diaz
• Susan E Duncan, LCSW

• Dentist in Bernalillo, NM
• Providers in Bernalillo, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.