John Taylor Matthew Davis, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

122300000X Issued in AL

Practice address

30 S Shore Dr
Destin, FL 32550-5821

Phone

(205) 994-5417

NPI assigned

Mar 11, 2017

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

• JT Davis Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mission Dental Mobile LLC

  dba Miles of Smiles

  • Dentist
  • Bessemer, AL
  • NPI 1205694932
  NPD (past)

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

{
    "created_epoch": "1489190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1871034702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S SHORE DR",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325505821",
            "telephone_number": "205-994-5417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S SHORE DR",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325505821",
            "telephone_number": "205-994-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOHN TAYLOR",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-11",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AL",
            "license": "122300000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JT",
            "last_name": "DAVIS",
            "credential": "D.M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Karen Anne Criswell, SLP
• Casey Cummings, PHARMD, BCPPS
• Ashley T Cusson, ARNP FNP-C
• Orijane Alma Dalton, PHARMD
• Carolyn Davis, M.D.
• Mary Davis, LPTA
• Sheila Davis, MD, MSPH, PHD, JDC
• Alexander James Decubellis
• Deep Waters PLLC
• Delta Health Group Inc (Delta Health Care Center)

• Endodontics in Destin, FL
• Providers in Destin, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; 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.