Individual provider Active NPI

Farrah Britney Davidson, D.D.S.

  • Dentist
  • Sterling Heights, MI
National Provider Identifier
1780979500
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020463 Issued in MI
Practice address
2041 15 Mile Rd
Sterling Heights, MI 48310-4801
Phone
(248) 202-2982
NPI assigned
Jun 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020463 MI Primary

Addresses

Primary practice location

2041 15 Mile Rd
Sterling Heights, MI 48310-4801

Mailing address

1492 Devon LN
Troy, MI 48084-7046
Phone (248) 202-2982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20160202000405 MI Order and Referring Only - DentistPractitioner - Dentist 9436453024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1780979500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 DEVON LN",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480847046",
            "telephone_number": "248-202-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104801",
            "telephone_number": "248-202-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "FARRAH",
        "middle_name": "BRITNEY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-09",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.