NPIMap

Organization Active NPI

Randall L Davis DMD PC

  • General Practice Dentistry
  • Lawrence, MA
National Provider Identifier
1831226117
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20413 Issued in MA
Legal business name
RANDALL L DAVIS DMD PC
Practice address
100 Amesbury St
Ste 203
Lawrence, MA 01840
Phone
(978) 686-8500
Fax
(978) 686-4032
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Authorized official

Name
Dr. Randall L Davis, DMDNPI 1487781605
Title
Owner
Phone
(978) 686-8500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 20413 MA Primary

Addresses

Primary practice location

100 Amesbury St
Ste 203
Lawrence, MA 01840

Mailing address

100 Amesbury St
Ste 203
Lawrence, MA 01840
Phone (978) 686-8500

Other identifiers 4

IdentifierTypeStateIssuer
X11220OtherMABC BS
9785914MedicaidMA
30312396OtherNHMEDICAI
046143185OtherMADELTA DENTAL

National Provider Directory

National Provider Directory
Tax ID family
Randall L Davis DMD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

100 Amesbury St
Ste 203
Lawrence, MA 01840
Phone (978) 686-8500

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1831226117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 AMESBURY ST",
            "address_2": "STE 203",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "01840",
            "telephone_number": "978-686-8500",
            "fax_number": "978-686-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 AMESBURY ST",
            "address_2": "STE 203",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "01840",
            "telephone_number": "978-686-8500",
            "fax_number": "978-686-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL L DAVIS DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-686-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "X11220",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9785914",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAI",
            "identifier": "30312396",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "046143185",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.