Dean Davis

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

06357783 Issued in ID

Practice address

3226 8TH St Apt J
Lewiston, ID 83501-4836

Phone

(208) 305-1964

NPI assigned

Jun 12, 2013

Last updated

Jun 12, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kenneth Dean Davis Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1811335854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 8TH ST APT J",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014836",
            "telephone_number": "208-305-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 8TH ST APT J",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014836",
            "telephone_number": "208-305-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DEAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "06357783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNETH",
            "last_name": "DAVIS",
            "middle_name": "DEAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dan R Wilson DDS PC
• Jenna Darnell
• Kathryn Ashley Datkuliak, LMT
• David M Brown, Crna PS
• Barbara Kay Davis, MD
• Larry Phillip Davis, MD
• Mona M Davis, NP
• Neely R Davis, PHARMD
• Rhonda Kaye Davis, LMT
• Vicki Gail Davis, RPH

• Massage Therapist in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.