Individual provider Active NPI

John Allen Davis, DMD

  • General Practice Dentistry
  • Rainbow City, AL
National Provider Identifier
1811087117
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3094 Issued in AL
Practice address
180 Independent Dr
Rainbow City, AL 35906-3286
Phone
(256) 442-7262
Fax
(256) 442-5760
NPI assigned
Oct 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3094 AL Primary

Addresses

Primary practice location

180 Independent Dr
Rainbow City, AL 35906-3286

Mailing address

180 Independent Dr
Rainbow City, AL 35906-3286
Phone (256) 442-7262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20150508001304 AL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2062731276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3094ALMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811087117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 INDEPENDENT DR",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "359063286",
            "telephone_number": "256-442-7262",
            "fax_number": "256-442-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 INDEPENDENT DR",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "359063286",
            "telephone_number": "256-442-7262",
            "fax_number": "256-442-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOHN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rainbow City, AL

Sources for this page

Verify at the official NPI Registry.