Dmitry Davy, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

047980 Issued in NY

Practice address

97-12 63 Drive
Unit CB
Rego Park, NY 11374

Phone

(718) 896-8700

Fax

(718) 896-0566

NPI assigned

Sep 14, 2006

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 NY

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780789552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97-12 63 DRIVE",
            "address_2": "UNIT CB",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "telephone_number": "718-896-8700",
            "fax_number": "718-896-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97-12 63 DRIVE",
            "address_2": "UNIT CB",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "telephone_number": "718-896-8700",
            "fax_number": "718-896-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVY",
        "first_name": "DMITRY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "047980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02110103",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stella Davidova, PHARM.D
• Larissa Davids, DDS
• Andrea Robin Davis, RD
• Brian Davis, LMSW
• Jennise Olivia Davis
• Oksana Davydov
• Rena Davydov
• Sergey Davydov, PHARM D.
• Violetta Davydov
• Yairkhay Davydov, DPT

• Dentist in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Dentist in New York

• 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.