Emeline T. Davis

Primary specialty

DentistTaxonomy code 122300000X

License

12008723 Issued in IN

Legal business name

EMELINE T. DAVIS

Practice address

2955 Professional LN
Terre Haute, IN 47802-3300

Phone

(812) 232-4664

Fax

(812) 234-5427

NPI assigned

Nov 9, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Emeline T. Davis, D.D.S.NPI 1770531071

Title

Dentist

Phone

(812) 232-4664

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Advanced Dental LLC Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emeline Taylor Davis, D.D.S.

  • General Practice Dentistry
  • Terre Haute, IN
  • NPI 1770531071
  NPD (past) Authorized official
• Angele Boghossian Mercho, D.D.S.

  • General Practice Dentistry
  • Terre Haute, IN
  • NPI 1811945116
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272240000000",
    "number": "1790766483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 PROFESSIONAL LN",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478023300",
            "telephone_number": "812-232-4664",
            "fax_number": "812-234-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 PROFESSIONAL LN",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478023300",
            "telephone_number": "812-232-4664",
            "fax_number": "812-234-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMELINE T. DAVIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2010-04-26",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "EMELINE",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "812-232-4664",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12008723",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009834",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12010103",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100251550A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dental LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.