Active NPI
Andrew Davis, DDS
- Public Health Dentistry
- Fort Worth, TX
National Provider Identifier
1770517351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 0022258
- Practice address
- 200 W Magnolia Ave
Suite 120
Fort Worth, TX 76104-7644 - Phone
- (817) 665-1323
- Fax
- (817) 871-9074
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 0022258 | TX | Primary |
Addresses
Primary practice location
200 W Magnolia Ave
Suite 120
Fort Worth, TX 76104-7644
Mailing address
200 W Magnolia Ave
Suite 120
Fort Worth, TX 76104-7644
Phone (817) 665-1323
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0022258 | Other | TX | DDS LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0022258 | TX | MD | Public Health Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770517351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W MAGNOLIA AVE",
"address_2": "SUITE 120",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761047644",
"telephone_number": "817-665-1323",
"fax_number": "817-871-9074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W MAGNOLIA AVE",
"address_2": "SUITE 120",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761047644",
"telephone_number": "817-665-1323",
"fax_number": "817-871-9074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ANDREW",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "TX",
"license": "0022258",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DDS LICENSE",
"identifier": "0022258",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.