James William Davis, D.M.D

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

021.001294 Issued in IL

Practice address

2025 W Iles Ave
Suite F
Springfield, IL 62704-4190

Phone

(217) 787-6761

Fax

(217) 787-6611

NPI assigned

Mar 11, 2010

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Springfield Periodontics LLC

  • Periodontics
  • Springfield, IL
  • NPI 1649342999
  NPD (past) Authorized official

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268265600000",
    "number": "1871816389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 W ILES AVE",
            "address_2": "SUITE F",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044190",
            "telephone_number": "217-787-6761",
            "fax_number": "217-787-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 W ILES AVE",
            "address_2": "SUITE F",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044190",
            "telephone_number": "217-787-6761",
            "fax_number": "217-787-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-11",
        "last_updated": "2010-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021.001294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE NPI",
            "identifier": "1649342999",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Austin Allen Davis
• Christie M Davis, PT
• Elle Murray Davis, MD
• Emily Davis
• Erin Michelle Davis
• Jennifer Davis, MS, RD, LDN
• Justin Davis
• Kaitlin Rose Davis, MD
• Karnesha Davis, RBT
• Krista Davis, DPT

• Periodontics in Springfield, IL
• Providers in Springfield, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.